| NPI | 1205554219 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VONDALYN WRIGHT Owner 813-800-6337 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2022-08-16 |
| Last Update Date | 2023-11-21 |