Organization
JAMAL ABOULHOSN (SOLE PROPRIETOR)
Active
Other names
EAST BROADWAY PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JAMAL ABOULHOSN RPH (OWNER,PIC,AO)
(502) 419-3936
Entity
Organization
Contact information
Practice address
2304 HURSTBOURNE VILLAGE DR, STE 700, LOUISVILLE, KY 40299-1853
(502) 589-1828
(502) 589-0263
Mailing address
2304 HURSTBOURNE VILLAGE DR, STE 700, LOUISVILLE, KY 40299-1853
(502) 589-1828
(502) 589-0263
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
P01589
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2030357
PK
—
05
—
54018379
—
KY
Enumeration date
09/12/2006
Last updated
08/11/2015
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