| NPI | 1033134952 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOLLY NICOLE WALDROP President 904-448-3336 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: FL PH26639) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2016-04-13 |