| NPI | 1225180722 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY MICHAEL DECRESCENZO President 772-567-2555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: FL PH12565) |
| Additional Taxonomies | 3336H0001X Pharmacy Home Infusion Therapy Pharmacy (Licence: FL PH19077) |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2020-08-22 |