| NPI | 1609111764 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BHARATH JANNU Pharmacy Manager 863-229-5974 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: FL PH26527) |
| Enumeration Date | 2012-11-30 |
| Last Update Date | 2016-09-27 |