Larry J & Bonnie P Russell
NPI #1710977442 in Elizabethtown, Kentucky
Provider Information
- NPI Number
- 1710977442
- Entity Type
- Organization
- Organization Name
- Larry J & Bonnie P Russell
- Primary Specialty
- Pharmacy - Community/Retail Pharmacy
- Enumeration Date
- Oct 25, 2005
- Last Updated
- Mar 7, 2023
Practice Location
- Address
- 910 N DIXIE AVE STE 105
- City
- Elizabethtown
- State
- Kentucky
- ZIP Code
- 42701-2519
- Phone
- (270) 769-3717
Authorized Official
- Name
- MR. LARRY RUSSELL, R.PH.
- Title
- OWNER
- Phone
- (270) 769-3717
Specialties & Taxonomy Codes
| Specialty |
|---|
| Pharmacy |
| Pharmacy - Community/Retail Pharmacy — Community/Retail Pharmacy |
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