| NPI | 1548514508 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE FOWLER COO 561-472-9990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: FL 602624) |
| Enumeration Date | 2012-10-30 |
| Last Update Date | 2013-01-24 |