| NPI | 1912217589 |
|---|---|
| Doing Business As | LAKE CUMBERLAND PHARMACY |
| Entity Type | Organization |
| Authorized Contact | JONATHAN GIDER Pharmacist In Charge 270-585-2221 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: KY P07417) |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336H0001X Pharmacy, Home Infusion Therapy Pharmacy | |
| 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition | |
| Enumeration Date | 2010-10-18 |
| Last Update Date | 2017-02-20 |