| NPI | 1568402212 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DALE GODBY Owner 270-422-2422 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: KY P06556) |
| Additional Taxonomies | 333600000X Pharmacy |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2007-10-18 |