| NPI | 1235254053 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES MICHAEL COPPEDGE President Pharmacist 239-573-2424 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: FL PH19550) |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2009-04-16 |