| NPI | 1124554100 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAM KOLTA Owner/ President 561-308-6738 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: FL PH30504) |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2017-05-11 |