| NPI | 1447442900 |
|---|---|
| Doing Business As | INDEPENDENCE HOME PHARMACY II |
| Entity Type | Organization |
| Authorized Contact | WILLIAM W HEWLETT President 270-753-5205 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336M0002X Pharmacy, Mail Order Pharmacy (Licence: KY P07204) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2007-08-17 |
| Last Update Date | 2008-01-07 |