| NPI | 1619258209 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN ROTH Pharmacy Manager 863-676-9496 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: FL PS44826) |
| Enumeration Date | 2011-09-08 |
| Last Update Date | 2011-09-08 |