Organization
COMMONWEALTH OF KENTUCKY
Active
Parent organization
COMMONWEALTH OF KENTUCKY
Other names
Hazelwood Center Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
COMMONWEALTH OF KENTUCKY
Authorized official
KATIE MARKS (COMMISSIONER)
(502) 782-6106
Entity
Organization
Contact information
Practice address
1800 BLUEGRASS AVE, LOUISVILLE, KY 40214
(502) 361-2301
Mailing address
1800 BLUEGRASS AVE, LOUISVILLE, KY 40214
(502) 361-2301
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
P05011
KY
Other
Enumeration date
10/26/2006
Last updated
10/20/2023
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