| NPI | 1245658236 |
|---|---|
| Doing Business As | MEDSOURCE PHARMACY |
| Entity Type | Organization |
| Authorized Contact | BAHER RIZKALLA Pharmacist/Owner 813-464-0563 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: FL PH27506) |
| Enumeration Date | 2014-04-07 |
| Last Update Date | 2014-04-07 |