| NPI | 1053350827 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAIN RUSK VP Pharmacy 863-688-1188 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: FL PH0021069) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2019-12-06 |