| NPI | 1023405545 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD JAY GRIFFIN Owner 904-318-2515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: FL 29038) |
| Additional Taxonomies | 3336C0004X Pharmacy, Compounding Pharmacy (Licence: FL 29038) |
| Enumeration Date | 2015-04-22 |
| Last Update Date | 2015-04-22 |