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General NPI Number Information
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NPI Number | 1912755919
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Entity Type | Organization
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Legal Business Name | TOMBERT INC
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Dates
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Enumeration Date | 05/07/2024
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Last Update Date | 05/07/2024
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Provider Practice Location Address
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Address Line | 815 COUNTRY CLUB LN
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City | HOPKINSVILLE
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State | KY
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Zip | 42240-1346
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Country | US
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Telephone | 270-885-1524
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Fax | 270-885-5022
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Provider Business Mailing Address
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Address Line | 815 COUNTRY CLUB LN
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City | HOPKINSVILLE
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State | KY
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Zip | 42240-1346
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Country | US
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Telephone | 270-885-1524
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Fax | 270-885-5022
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Authorized Official
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Title or Position | CEO
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Name | MARY KATHRINE DETRAZ
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Credential |
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Telephone | 270-885-1524
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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