| NPI | 1427421650 |
|---|---|
| Doing Business As | PARK STREET PHARMACY |
| Entity Type | Organization |
| Authorized Contact | MORGAN GRAHAM TATUM Owner 561-373-0577 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MI 5301010761) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2015-11-10 |
| Last Update Date | 2019-03-05 |