| NPI | 1184649493 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN BALLINA President/Owner 877-220-7909 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: FL PH21498) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2020-08-22 |