| NPI | 1669141008 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA ROBERTSON Manager 502-724-2018 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 183500000X Pharmacist |
| Enumeration Date | 2021-09-09 |
| Last Update Date | 2022-04-28 |