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General NPI Number Information
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NPI Number | 1124990676
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Entity Type | Organization
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Legal Business Name | EMAX HEALTH PATIENT SERVICES
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Dates
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Enumeration Date | 09/23/2025
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Last Update Date | 09/29/2025
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Provider Practice Location Address
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Address Line | 1840 OUTER LOOP STE A-101
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City | LOUISVILLE
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State | KY
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Zip | 40219-3429
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Country | US
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Telephone | 812-989-5406
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Fax |
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Provider Business Mailing Address
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Address Line | 306 SQUIRE HILL DR
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City | OTISCO
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State | IN
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Zip | 47163-9609
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | DR. KAYLA MARIE CLARK
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Credential | PHARMD, RPH
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Telephone | 812-989-5406
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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 |
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License Number State |
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