| NPI | 1295425718 |
|---|---|
| Doing Business As | PHARMACY #1773 |
| Entity Type | Organization |
| Authorized Contact | DAIN RUSK Vice President Of 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 | 2023-05-09 |
| Last Update Date | 2023-06-21 |