| NPI | 1528616596 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN J GASPELIN Director Of Finance/Revenue 321-841-6308 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Additional Taxonomies | 3336S0011X Pharmacy Specialty Pharmacy |
| Enumeration Date | 2019-09-03 |
| Last Update Date | 2019-09-03 |