| NPI | 1154674968 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAM PRASAD CHOUDHURY Manager 941-752-4302 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: FL PH26427) |
| Additional Taxonomies | 3336C0004X Pharmacy Compounding Pharmacy (Licence: FL PH26427) |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: FL PH26427) | |
| Enumeration Date | 2012-10-17 |
| Last Update Date | 2016-10-19 |