| NPI | 1891792057 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICK R TIMMONS Owner/Operator 270-443-7200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: KY PO6149) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: KY 90380734) |
| 3336H0001X Pharmacy, Home Infusion Therapy Pharmacy (Licence: KY PO6149) | |
| 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: KY PO6149) | |
| Enumeration Date | 2005-07-02 |
| Last Update Date | 2013-11-05 |