| NPI | 1841486156 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAM DAULTON Owner 606-679-1169 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: KY P07849) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: KY 7100039650) |
| 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: KY P07206) | |
| Enumeration Date | 2007-09-20 |
| Last Update Date | 2019-01-30 |