NPI | 1578992624 |
---|---|
Entity Type | Organization |
Authorized Contact | MARY CHEN Chief Operation Officer 305-628-6117 |
Organization Subpart ? | Yes |
Primary Taxonomy | 174400000X Specialist (Licence: FL ME88821) |
Additional Taxonomies | 332900000X Non-Pharmacy Dispensing Site |
Enumeration Date | 2013-11-08 |
Last Update Date | 2015-02-02 |