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General NPI Number Information
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NPI Number | 1982253613
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Entity Type | Organization
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Legal Business Name | BELLA LASLEY LLC
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Dates
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Enumeration Date | 09/05/2019
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Last Update Date | 07/17/2020
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Provider Practice Location Address
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Address Line | 308 S PINE ST
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City | PINEVILLE
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State | KY
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Zip | 40977-1735
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Country | US
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Telephone | 606-337-8300
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Fax | 606-337-8398
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Provider Business Mailing Address
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Address Line | 308 S PINE ST
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City | PINEVILLE
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State | KY
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Zip | 40977-1735
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Country | US
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Telephone | 606-337-8300
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Fax | 606-337-8398
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Authorized Official
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Title or Position | OWNER
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Name | MICHAEL ANDREW SCHNEIDER
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Credential |
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Telephone | 606-337-8300
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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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