| NPI | 1568748010 |
|---|---|
| Doing Business As | ADVANCED RX 064 |
| Entity Type | Organization |
| Authorized Contact | ADAM GIRAULT Program Manager 813-543-9041 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336M0003X Pharmacy, Managed Care Organization Pharmacy (Licence: CA WLS 5655) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2011-10-28 |
| Last Update Date | 2023-06-26 |