Organization
CENTRAL STATE HOSPITAL PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PATRICIA P BRODIE (HOSPITAL DIRECTOR)
(502) 253-7000
Entity
Organization
Contact information
Practice address
10510 LAGRANGE RD, LOUISVILLE, KY 40223-1277
(502) 253-7000
Mailing address
10510 LAGRANGE RD, LOUISVILLE, KY 40223-1277
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
P05065
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
54025408
—
KY
Enumeration date
09/20/2006
Last updated
08/20/2009
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