| NPI | 1679660823 |
|---|---|
| Doing Business As | CLINIC PHARMACY |
| Entity Type | Organization |
| Authorized Contact | SHANE FOGLE PIC 270-754-4300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: KY P00339) |
| Additional Taxonomies | 3336C0002X Pharmacy, Clinic Pharmacy |
| 3336C0004X Pharmacy, Compounding Pharmacy | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 333600000X Pharmacy | |
| Enumeration Date | 2006-10-09 |
| Last Update Date | 2020-05-16 |