Organization
DIXIE PHARMACY LLC
Active
Other names
Dixie Pharmacy LLC
Organization subpart
No
Provider details
NPI number
Authorized official
NAVAS YOONUS (OWNER, CEO)
(615) 525-3142
Entity
Organization
Contact information
Practice address
8442 DIXIE HWY STE 100, LOUISVILLE, KY 40258-1140
(502) 812-1920
(502) 812-1921
Mailing address
914 N DIXIE AVE, STE 103, ELIZABETHTOWN, KY 42701-2520
(270) 900-1584
(270) 900-1594
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
P07632
KY
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2145654
PK
—
05
—
7100316680
—
KY
Enumeration date
05/08/2014
Last updated
06/27/2016
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