Organization
AFTON PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDA ROBERTSON (MANAGER)
(502) 724-2018
Entity
Organization
Contact information
Practice address
4400 BRECKENRIDGE LN STE 100, LOUISVILLE, KY 40218-4082
(812) 817-0198
(812) 827-2485
Mailing address
4400 BRECKENRIDGE LN STE 100, LOUISVILLE, KY 40218-4082
(812) 817-0198
(812) 827-2485
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100771460
—
KY
Enumeration date
09/09/2021
Last updated
04/28/2022
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