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A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Clinic Pharmacy |
3336C0002X | 58 | Medical Supply Company with Pharmacist | |
Community/Retail Pharmacy |
3336C0003X | 58 | Medical Supply Company with Pharmacist | |
Pharmacy |
333600000X | 58 | Medical Supply Company with Pharmacist |
| NPI Number | 1093274458 |
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| LBN Legal business name | KSR HEALTH CARE LLC | ||||
| Authorized official | SIMEON ROTH - (PHARMACY MANAGER) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | No | ||||
| Enumeration date | 03/15/2019 | ||||
| Last updated | 03/10/2022 - About 4 years ago | ||||
| Identifiers |
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KSR HEALTH CARE LLC
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KSR HEALTH CARE LLC