| NPI | 1649092115 |
|---|---|
| Doing Business As | KENTUCKYCARE PHARMACY 145 |
| Entity Type | Organization |
| Authorized Contact | TALMAGE WHITEHEAD CFO 870-347-2534 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2024-10-28 |
| Last Update Date | 2025-05-02 |