Organization
INGRAM & BALL, PLLC
Active
Other names
Heartland Primary Care Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
GARY GREEN (MANAGER)
(502) 939-6085
Entity
Organization
Contact information
Practice address
2412 RING RD STE 200, ELIZABETHTOWN, KY 42701-5913
(270) 765-5926
(866) 263-2295
Mailing address
3206 WILDWOOD TRL, LA GRANGE, KY 40031-8232
(502) 939-6085
(866) 263-2295
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
P07691
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2152359
PK
—
Enumeration date
06/05/2015
Last updated
06/05/2015
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