Organization
BARDWELL PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL SHAWN BOAZ PHARM D (PHARM D)
(270) 628-5445
Entity
Organization
Contact information
Practice address
178 U.S. HWY 51 N, BARDWELL, KY 42023
(270) 628-5445
(270) 628-3179
Mailing address
178 U.S. HWY 51 N, BARDWELL, KY 42023
(270) 628-5445
(270) 628-3179
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
P06353
KY
Other
Enumeration date
06/05/2015
Last updated
08/19/2024
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