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General NPI Number Information
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NPI Number | 1023109212
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Entity Type | Organization
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Legal Business Name | VALUE RX BLUEGRASS LLC
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Dates
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Enumeration Date | 09/27/2006
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Last Update Date | 06/21/2017
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Provider Practice Location Address
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Address Line | 2446 ANDERSON RD
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City | CRESCENT SPRINGS
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State | KY
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Zip | 41017
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Country | US
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Telephone | 859-341-1660
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Fax | 859-344-4142
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Provider Business Mailing Address
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Address Line | 2446 ANDERSON RD
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City | CRESCENT SPRINGS
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State | KY
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Zip | 41017
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Country | US
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Telephone | 859-341-1660
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Fax | 859-344-4142
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Authorized Official
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Title or Position | OWNER
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Name | MS. TODD WALTERS
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Credential | RPH
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Telephone | 606-269-2965
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | P07830
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License Number State | KY
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