| NPI | 1649336348 |
|---|---|
| Other Name | PHARMACY DME |
| Entity Type | Organization |
| Authorized Contact | MARK WILSON MEADOR President Pharmacist Owner 270-237-4446 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: KY P06611) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: KY 90030024) |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2012-11-29 |