| NPI | 1063707818 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SIMPLICE ESSOU Owner 317-441-8614 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: FL PH25434) |
| Enumeration Date | 2011-06-09 |
| Last Update Date | 2011-06-09 |