| NPI | 1477573780 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GWEN CORTNEY PARKER Lead Pharmacy Tech Asst Manager 863-533-4102 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: FL PH19) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2020-08-22 |