| NPI | 1609319367 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | UDAY PATEL Manager 321-586-5500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: FL 30482) |
| Additional Taxonomies | 3336C0004X Pharmacy Compounding Pharmacy |
| 3336C0003X Pharmacy Community/Retail Pharmacy | |
| Enumeration Date | 2016-11-29 |
| Last Update Date | 2017-01-20 |