| NPI | 1477030674 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN THEODORE MOUGEOT President/Owner/Director 904-860-4948 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: FL PH31462) |
| Enumeration Date | 2018-07-20 |
| Last Update Date | 2018-07-20 |