| NPI | 1518406487 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAYCEE LYNN SUTTER Owner 808-312-8738 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336S0011X Pharmacy Specialty Pharmacy (Licence: FL PH30612) |
| Additional Taxonomies | 3336C0002X Pharmacy Clinic Pharmacy (Licence: FL PH30612) |
| 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: FL PH30612) | |
| Enumeration Date | 2017-02-13 |
| Last Update Date | 2017-02-13 |