| NPI | 1649775693 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS BRAUN Pharmacy Manager 239-273-8821 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 3336S0011X Pharmacy, Specialty Pharmacy | |
| Enumeration Date | 2018-03-29 |
| Last Update Date | 2021-01-22 |