| NPI | 1104375971 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TODD TROXELL Pharmacy Manager/Owner 904-500-8769 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: FL PH30367) |
| Enumeration Date | 2016-09-22 |
| Last Update Date | 2016-09-22 |