NPI | 1508223140 |
---|---|
Entity Type | Organization |
Authorized Contact | KATHLEEN VAES Owner 813-205-4550 |
Organization Subpart ? | No |
Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: FL ME67888) |
Enumeration Date | 2016-01-27 |
Last Update Date | 2021-01-19 |