| NPI | 1417079328 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAFALI DATA Pharmacist In Charge 866-442-2866 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: FL PH21582) |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2020-08-22 |