| Organization Name: | BET PHARM, LLC |
| NPI Number: | 1003213927 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ROBERT DOUGLAS (MANAGING OWNER) |
| Mailing Address: | 1501 Bull Lea Rd Suite 102b Lexington |
| State: | KY US |
| Postal Code: | 405111285 |
| Phone Number: | 8592732930 |
| Fax Number: | 8592732860 |
| NPI Enumeration Date: | 11/20/2014 |
| NPI Last Update Date: | 11/20/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 3336C0004X |
| License Number: | P06814 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KY |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Pharmacy |
| Taxonomy Specialization: | Compounding Pharmacy |
| Taxonomy Definition: | A pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner |