| NPI | 1215219241 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARA DENYSE MENESICK Registered Immunizing Pharmacist 772-215-2490 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: FL PS47625) |
| Enumeration Date | 2011-09-15 |
| Last Update Date | 2011-09-15 |