NPI | 1801990866 |
---|---|
Doing Business As | EAST BROADWAY PHARMACY |
Entity Type | Organization |
Authorized Contact | JAMAL ABOULHOSN Owner,PIC,AO 502-419-3936 |
Organization Subpart ? | No |
Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: KY P01589) |
Additional Taxonomies | 333600000X Pharmacy |
Enumeration Date | 2006-09-12 |
Last Update Date | 2015-08-11 |