| NPI | 1114296050 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SRILATHA ANUMASU Pharmacist 386-586-3830 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: FL PS38551) |
| Enumeration Date | 2011-12-21 |
| Last Update Date | 2011-12-21 |