| NPI | 1205328663 |
|---|---|
| Other Name | ST.CLOUD COMPOUNDING PHARMACY AND WELLNESS CENTER |
| Entity Type | Organization |
| Authorized Contact | SAJI THOMAS Employee 407-593-2959 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: FL PH31091) |
| Enumeration Date | 2018-06-01 |
| Last Update Date | 2018-06-01 |