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General NPI Number Information
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NPI Number | 1942998448
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Entity Type | Organization
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Legal Business Name | DERBY PHARMACY LLC
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Dates
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Enumeration Date | 04/24/2023
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Last Update Date | 06/28/2023
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Provider Practice Location Address
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Address Line | 501 PARKER PL UNIT 100
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City | LA GRANGE
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State | KY
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Zip | 40031-2231
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Country | US
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Telephone | 502-265-0020
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Fax | 502-265-0107
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Provider Business Mailing Address
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Address Line | 501 PARKER PL UNIT 100
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City | LA GRANGE
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State | KY
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Zip | 40031-2231
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Country | US
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Telephone | 502-265-0020
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Fax | 502-265-0107
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Authorized Official
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Title or Position | OWNER
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Name | ANURADHA ALUR
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Credential |
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Telephone | 502-758-1205
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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 |
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License Number State |
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