| NPI | 1487665980 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN MARTYN President 753-218-0862 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: FL PH22102) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2020-08-22 |