| NPI | 1558740209 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NIRAJ BANJARA Pharmacy Manager 239-297-0876 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: FL PH29130) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 3336C0004X Pharmacy Compounding Pharmacy | |
| 333600000X Pharmacy | |
| Enumeration Date | 2015-05-28 |
| Last Update Date | 2024-06-08 |