| NPI | 1548329014 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIAHN CLARK Owner 321-253-3535 |
| Organization Subpart ? | No |
| Primary Taxonomy | 183500000X Pharmacist |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PH18030) |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2023-03-07 |