| NPI | 1427233584 |
|---|---|
| Doing Business As | LANE AVENUE PHARMACY |
| Entity Type | Organization |
| Authorized Contact | FELIX OBASUYI Owner / Pharmacist 904-693-6633 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: FL PH23097) |
| Enumeration Date | 2008-01-08 |
| Last Update Date | 2010-06-14 |