| NPI | 1184719361 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDGAR H WISE President/Pharmacist 352-372-4371 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: FL PH373) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: FL PH373) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2020-08-22 |