| NPI | 1366777492 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AARON CROWLEY CFO 863-662-7990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: IL 054-016725) |
| Additional Taxonomies | 3336M0002X Pharmacy, Mail Order Pharmacy (Licence: IL 054-016725) |
| Enumeration Date | 2009-10-07 |
| Last Update Date | 2009-10-21 |