| NPI | 1386033736 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIBHA CHOUDHARY Pharmacy Director 386-456-1500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy Long Term Care Pharmacy (Licence: FL PH28804) |
| Enumeration Date | 2015-01-22 |
| Last Update Date | 2015-02-23 |