Organization
NUTRISHARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AUSTIN PULSIPHER (PRESIDENT)
(916) 478-7811
Entity
Organization
Contact information
Practice address
11020 PLANTSIDE DR, LOUISVILLE, KY 40299-6105
(502) 297-0222
(916) 478-7924
Mailing address
9850 KENT ST, ELK GROVE, CA 95624-9483
(916) 685-5034
(916) 478-7924
Taxonomy
Speciality
Code
Description
License number
State
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
P06292
KY
3336H0001X
Home Infusion Therapy Pharmacy
Primary
—
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1831393
NCPDP
—
01
—
P08194
PHARMACY
KY
Enumeration date
03/10/2007
Last updated
03/07/2023
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