| NPI | 1124369020 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOLLY LOPEZ VP Support Services 305-500-2108 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: FL ME108511) |
| Enumeration Date | 2013-03-04 |
| Last Update Date | 2013-03-04 |