| NPI | 1437543469 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTIN BLOOM Owner 561-368-8886 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: FL ME27887) |
| Enumeration Date | 2015-03-27 |
| Last Update Date | 2015-03-27 |