Organization Name: | LARRY J & BONNIE P RUSSELL |
NPI Number: | 1710977442 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LARRY RUSSELL (OWNER) |
Mailing Address: | 910 N Dixie Ave Ste 105 Elizabethtown |
State: | KY US |
Postal Code: | 427012519 |
Phone Number: | 2707693717 |
Fax Number: | 2707692887 |
NPI Enumeration Date: | 10/25/2005 |
NPI Last Update Date: | 02/01/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 333600000X |
License Number: | P01397 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | KY |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Pharmacy |
Taxonomy Specialization: | |
Taxonomy Definition: | A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |