Organization
STATE PHARM INC
Active
Other names
State Pharm
Organization subpart
No
Provider details
NPI number
Authorized official
KIM GORSKI (OWNER)
(502) 583-5636
Entity
Organization
Contact information
Practice address
825 S 6TH ST, LOUISVILLE, KY 40203-2123
(502) 583-5636
(502) 562-1235
Mailing address
825 S 6TH ST, LOUISVILLE, KY 40203-2123
(502) 583-5636
(502) 562-1235
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
P07455
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2125320
PK
—
Enumeration date
02/19/2010
Last updated
06/10/2015
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