| NPI | 1003261587 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAIN RUSK VP Pharmacy 863-688-1188 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: FL PH30293) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 3336C0003X Pharmacy Community/Retail Pharmacy | |
| Enumeration Date | 2016-05-03 |
| Last Update Date | 2019-12-06 |