| NPI | 1366597015 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALVIN MICHAEL MCCLAIN Pharmacy Manager 904-272-1919 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy, Compounding Pharmacy (Licence: FL PH18362) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: FL PH18362) |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2025-09-11 |