Organization
PPC 001
Active
Other names
PPC
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY CAMPBELL (OWNER)
(812) 288-2488
Entity
Organization
Contact information
Practice address
3012 EASTPOINT PKWY, LOUISVILLE, KY 40223-4185
(812) 288-2488
Mailing address
1804 E 10TH ST, JEFFERSONVILLE, IN 47130-6016
(812) 288-2488
(812) 288-6603
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
P07624
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2144934
PK
—
Enumeration date
04/03/2014
Last updated
04/03/2014
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