Organization
MIDDLETOWN PHARMACIST GROUP
Active
Other names
Middletown Pharmacy & Wellness-LTC
Organization subpart
No
Provider details
NPI number
Authorized official
MARY BOGGESS (OWNER)
(502) 690-2410
Entity
Organization
Contact information
Practice address
11601 SHELBYVILLE RD STE A, LOUISVILLE, KY 40243-1309
(502) 690-2410
Mailing address
11601 SHELBYVILLE RD STE A, LOUISVILLE, KY 40243-1309
(502) 690-2410
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100717140
—
KY
Enumeration date
06/09/2022
Last updated
06/09/2022
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