| NPI | 1053540104 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOLLY LOPEZ VP, Support Services 305-500-2108 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: FL ME13125) |
| Enumeration Date | 2009-07-10 |
| Last Update Date | 2009-07-10 |