| NPI | 1538488945 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MANDEL JERMAINE HEARNS Pharmacist 904-778-0871 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: FL PS33463) |
| Enumeration Date | 2010-05-25 |
| Last Update Date | 2010-05-25 |