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>> Pharmacist >> Pharmacy Service Providers

Registrant NPI Number: 1962729566

Individual Registrant:
Gender: M
Sole Proprietor

Location and contact information for practice:
Tel: 606-633-9238  Fax: 606-633-0222

Contact information for business:
PO BOX 250  ISOM, KY 41824-0250 US
Tel: 606-633-9238  Fax: 606-633-0222

Registration Information:
NPI: 1962729566
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y183500000XPharmacy Service Providers

Legacy codes, insurance codes and state license numbers:



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