NPI | 1043652761 |
---|---|
Entity Type | Organization |
Authorized Contact | MICHAEL BARILE Physician 239-325-2909 |
Organization Subpart ? | Yes |
Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: FL ME75050) |
Enumeration Date | 2013-07-23 |
Last Update Date | 2013-09-17 |