| NPI | 1508324021 |
|---|---|
| Doing Business As | MINNEOLA PHARMACY |
| Entity Type | Organization |
| Authorized Contact | JAN R GRANADOS Manager/Member 620-885-4544 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Enumeration Date | 2019-03-04 |
| Last Update Date | 2021-05-11 |