Organization
CPO PSC
Active
Other names
Rx Advantage 001
Organization subpart
No
Provider details
NPI number
Authorized official
LAWRENCE PETERS PHARMD (MD)
(502) 368-9591
Entity
Organization
Contact information
Practice address
4402 CHURCHMAN AVE STE 404, LOUISVILLE, KY 40215-3102
(502) 368-9591
(866) 263-2295
Mailing address
4402 CHURCHMAN AVE STE 404, LOUISVILLE, KY 40215-3102
(502) 368-9591
(866) 263-2295
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
P07630
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2145867
PK
—
Enumeration date
01/22/2013
Last updated
06/15/2022
About Stedi
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