| NPI | 1437514429 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDELL SHORT Pharmacist 606-436-0686 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: KY P06120) |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336C0004X Pharmacy Compounding Pharmacy | |
| 3336H0001X Pharmacy Home Infusion Therapy Pharmacy | |
| 3336M0002X Pharmacy Mail Order Pharmacy | |
| 3336S0011X Pharmacy Specialty Pharmacy | |
| Enumeration Date | 2015-12-18 |
| Last Update Date | 2015-12-18 |