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Organization

YOUR PHARMACY LLC

Active
Other names
YOUR PHARMACY
Organization subpart
No

Provider details

NPI number
Authorized official
JOSHUA SORRELL BS, MGT (OWNER)
(859) 234-5400
Entity
Organization

Contact information

Practice address
208 W PLEASANT ST, STE 2, CYNTHIANA, KY 41031-2421
(859) 234-5400
(859) 234-5399
Mailing address
208 W PLEASANT ST, STE 2, CYNTHIANA, KY 41031-2421
(859) 234-5400
(859) 234-5399

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
333600000X
Pharmacy
Primary
3336C0003X
Community/Retail Pharmacy
P06952
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1826277
NCPDP PROVIDER IDENTIFICATION NUMBER
05
54000294
KY
Enumeration date
01/13/2006
Last updated
12/18/2017
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