NPI | 1053039743 |
---|---|
Entity Type | Organization |
Authorized Contact | ERIC J LARSON Authorized Member 407-750-9313 |
Organization Subpart ? | No |
Primary Taxonomy | 333600000X Pharmacy |
Additional Taxonomies | 3336C0002X Pharmacy, Clinic Pharmacy |
3336S0011X Pharmacy, Specialty Pharmacy | |
Enumeration Date | 2022-08-18 |
Last Update Date | 2022-08-18 |