Organization
JAMAL ABOULHOSN (SOLE PROPRIETOR)
Active
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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