Organization
CENTRAL STATE HOSPITAL
Active
Other names
CENTRAL STATE HOSPITAL PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JOE MCCULLEN (SENIOR CONTROLLER)
(502) 253-7000
Entity
Organization
Contact information
Practice address
10510 LA GRANGE RD, LOUISVILLE, KY 40223-1277
(502) 253-7337
(502) 253-7344
Mailing address
10510 LA GRANGE RD, LOUISVILLE, KY 40223-1277
(502) 253-7337
(502) 253-7344
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
—
—
3336I0012X
Institutional Pharmacy
Primary
P05065
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2118602
PK
—
05
—
54025408
—
KY
Enumeration date
01/20/2009
Last updated
04/22/2013
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