| NPI | 1053656207 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA GALCERAN Operations Manager 407-451-7624 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: CO 17022) |
| Enumeration Date | 2012-11-28 |
| Last Update Date | 2012-12-17 |