| NPI | 1568474625 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMARA BENTLEY MAYNARD Owner/Pharmacist 606-789-4410 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: KY P07059) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: KY P07059) |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2023-03-07 |