| NPI | 1083293922 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE JADE FRICKS Owner 850-665-4657 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2021-04-07 |
| Last Update Date | 2021-04-07 |