NPI | 1093849747 |
---|---|
Entity Type | Organization |
Authorized Contact | MICHAEL LAMENSDORF Owner 941-957-4987 |
Organization Subpart ? | No |
Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: FL DO4520) |
Enumeration Date | 2007-03-15 |
Last Update Date | 2008-04-23 |