| NPI | 1053137612 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AISHA GRANT Owner 561-360-6008 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336C0004X Pharmacy Compounding Pharmacy | |
| 3336L0003X Pharmacy Long Term Care Pharmacy | |
| Enumeration Date | 2024-11-28 |
| Last Update Date | 2024-11-28 |