| NPI | 1356608772 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MITCHELL KRASSAN Chief Strategy Officer 561-961-1921 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: FL 1376866) |
| Enumeration Date | 2012-04-23 |
| Last Update Date | 2012-04-23 |