| NPI | 1003977174 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NELLIE BORBA NASSIROU President 904-894-9565 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: FL PH22399) |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2008-06-26 |