| NPI | 1639592884 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOLLY LOPEZ VP Support Services 305-500-2108 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: FL ME50728) |
| Enumeration Date | 2014-01-23 |
| Last Update Date | 2014-01-23 |