| NPI | 1407236573 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE FAYE CONKLIN Pharmacist 239-823-5898 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: FL ps49330) |
| Enumeration Date | 2015-06-04 |
| Last Update Date | 2015-06-04 |