| NPI | 1063990521 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAJI SAMUEL Pharmacy Manager/ Owner 954-803-5729 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Additional Taxonomies | 3336S0011X Pharmacy, Specialty Pharmacy (Licence: FL PH31569) |
| Enumeration Date | 2018-08-06 |
| Last Update Date | 2023-01-10 |