| NPI | 1528173598 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORENZO TALMADGE STEWART Pharmacist 850-433-0031 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: FL PH0001202) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2020-08-22 |