| NPI | 1073978110 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA MARIE SHIERS Secretary 239-317-3033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: FL PH29928) |
| Enumeration Date | 2015-12-16 |
| Last Update Date | 2024-07-17 |