| NPI | 1952402992 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY FORTENBERRY Co Owner 606-432-2424 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: KY P06850) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2008-02-11 |