| NPI | 1528604345 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK W DICKINSON CFO 407-905-8827 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 3336C0002X Pharmacy, Clinic Pharmacy |
| Enumeration Date | 2019-11-27 |
| Last Update Date | 2024-08-12 |