| NPI | 1457784530 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KERRY NICKLAS Director Of Compliance &Admin 727-302-8135 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2013-08-13 |
| Last Update Date | 2015-11-13 |