| NPI | 1003464132 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAWANA MICHELE BARNHART Registered Agent 561-302-0045 |
| Organization Subpart ? | |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Enumeration Date | 2019-09-02 |
| Last Update Date | 2019-09-02 |