| NPI | 1427578731 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK J. THEOBALD President/CEO 239-939-9226 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: FL PH30971) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2017-06-27 |
| Last Update Date | 2018-04-05 |