| NPI | 1922197607 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIS ESTEPHENE President 502-712-2299 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: KY PO6456) |
| Additional Taxonomies | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2020-08-22 |