| NPI | 1588097828 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWRENCE E. MANN Pharmacist In Charge 954-210-7350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: FL PH26971) |
| Additional Taxonomies | 3336C0004X Pharmacy Compounding Pharmacy (Licence: FL PH26971) |
| Enumeration Date | 2013-08-09 |
| Last Update Date | 2015-09-26 |