| NPI | 1225580921 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAIN RUSK VP Pharmacy 863-688-1188 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 333600000X Pharmacy | |
| Enumeration Date | 2016-10-28 |
| Last Update Date | 2019-12-03 |