| NPI | 1790863710 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDELL D BOGGS President Pharmacist 606-832-2121 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: KY 3336C0003X) |
| Additional Taxonomies | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: KY P02547) |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: KY P02547) | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2008-08-26 |