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General NPI Number Information
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NPI Number | 1225521081
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Entity Type | Organization
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Legal Business Name | BN SPECIALTY, LLC
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Dates
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Enumeration Date | 06/07/2018
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Last Update Date | 06/07/2018
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Provider Practice Location Address
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Address Line | 5111 COMMERCE CROSSINGS DR STE 100
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City | LOUISVILLE
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State | KY
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Zip | 40229-2192
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Country | US
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Telephone | 502-792-8258
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Fax | 502-792-8158
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Provider Business Mailing Address
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Address Line | 5111 COMMERCE CROSSINGS DR SUITE 100
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City | LOUISVILLE
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State | KY
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Zip | 40229-2191
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Country | US
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Telephone | 502-792-8258
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Fax | 502-792-8158
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Authorized Official
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Title or Position | OFFICER
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Name | BACH NGUYEN
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Credential |
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Telephone | 502-792-8258
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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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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | P08002
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License Number State | KY
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