| NPI | 1346239332 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANA W SOPER CEO 904-855-0040 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336H0001X Pharmacy, Home Infusion Therapy Pharmacy (Licence: FL PH 13657) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS 26357) |
| 1835N1003X Pharmacist, Nutrition Support (Licence: FL PS 26357) | |
| 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: FL PH 13657) | |
| 3336S0011X Pharmacy, Specialty Pharmacy (Licence: FL PH 13657) | |
| Enumeration Date | 2005-10-21 |
| Last Update Date | 2008-07-16 |