| NPI | 1497860423 |
|---|---|
| Doing Business As | WALLACE PHARMACY |
| Doing Business As | MEDICINE SHOPPE |
| Entity Type | Organization |
| Authorized Contact | WAYNE WALLACE Owner/R Ph 941-627-9855 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy (Licence: FL PH9089) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2023-03-07 |