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General NPI Number Information
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NPI Number | 1376648659
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Entity Type | Organization
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Legal Business Name | UL CLINIC LLC
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Dates
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Enumeration Date | 09/13/2006
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Last Update Date | 12/18/2024
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Provider Practice Location Address
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Address Line | 137 N. LEVISA RD.
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City | MOUTHCARD
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State | KY
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Zip | 41548
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Country | US
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Telephone | 606-835-4991
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Fax | 606-835-4219
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Provider Business Mailing Address
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Address Line | 137 N LEVISA RD
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City | MOUTHCARD
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State | KY
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Zip | 41548-8116
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Country | US
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Telephone | 606-835-4991
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Fax | 606-835-4219
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Authorized Official
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Title or Position | PRESIDENT
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Name | PETER SAAD
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Credential |
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Telephone | 318-259-7334
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | P01788
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License Number State | KY
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