Lake Cumberland Pharmacy LLC
NPI #1912201906 in Russell Springs, Kentucky
Provider Information
- NPI Number
- 1912201906
- Entity Type
- Organization
- Organization Name
- Lake Cumberland Pharmacy LLC
- Primary Specialty
- Pharmacy - Community/Retail Pharmacy
- Enumeration Date
- Jan 5, 2011
- Last Updated
- Oct 7, 2022
Practice Location
- Address
- 124 DOWELL RD
- City
- Russell Springs
- State
- Kentucky
- ZIP Code
- 42642-4278
- Phone
- (270) 866-2686
Authorized Official
- Name
- JONATHAN GRIDER, PHARMD
- Title
- MANAGING MEMBER
- Phone
- (270) 858-6400
Specialties & Taxonomy Codes
| Specialty |
|---|
| Durable Medical Equipment & Medical Supplies - Parenteral & Enteral Nutrition — Parenteral & Enteral Nutrition |
| Pharmacy |
| Pharmacy - Community/Retail Pharmacy — Community/Retail Pharmacy |
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