| NPI | 1568179489 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLAYTON D EDWARDS Vice President 772-631-7376 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336M0002X Pharmacy, Mail Order Pharmacy |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2022-10-31 |
| Last Update Date | 2024-01-10 |