| NPI | 1477666956 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN CHRISTOPHER BLANCO President/ Pharmacy Manager 904-461-1081 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: FL ph20073) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2016-08-04 |