| NPI | 1427096809 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOKUNBO NIKE KASSIM Dir, Pharmacist In Charge 959-299-3008 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336M0002X Pharmacy, Mail Order Pharmacy (Licence: FL PH21465) |
| Additional Taxonomies | 333600000X Pharmacy (Licence: FL PH21465) |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2019-03-01 |