| NPI | 1962642611 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA DENISE PORTER Cheif Pharmacist 606-928-6414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2009-02-20 |
| Last Update Date | 2009-02-20 |