Provider Information for 1912774050
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KY PHARMACY
Other Names:Doing Business As:KENTUCKY PHARMACYOrganization Subpart: NO
NPI: 1912774050
Last Updated: 2024-01-27
Certification Date: 2024-01-27
Certification Date: 2024-01-27
Details
Name | Value | ||||||||
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NPI | 1912774050 | ||||||||
Enumeration Date | 2023-12-08 | ||||||||
NPI Type | NPI-2 Organization | ||||||||
Status | Active | ||||||||
Authorized Official Information | Name: VY TRUONG Title: CEO/PIC Phone: 7819750705 | ||||||||
Mailing Address | 4102 SANCTUARY BLUFF LN LOUISVILLE, KY 40241-5872 United States Phone: 781-975-0705 | Fax:502-415-7346 | ||||||||
Primary Practice Address | 2233 LOWER HUNTERS TRCE LOUISVILLE, KY 40216-1358 United States Phone: 502-289-3797 | Fax: | ||||||||
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