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Provider Information for 1912774050


The following NPI(s) contain information matching your search criteria. Please select the NPI to view all the data associated with the NPI.

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KY PHARMACY

Other Names:  
Doing Business As: 
KENTUCKY PHARMACY

Organization Subpart: NO

NPI: 1912774050
Last Updated: 2024-01-27
Certification Date: 2024-01-27

Details

NameValue
NPI1912774050
Enumeration Date2023-12-08
NPI TypeNPI-2 Organization
StatusActive
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:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 3336C0003X - Pharmacy - Community/Retail Pharmacy