| NPI | 1649871583 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA ALLEN DAVIS Director Of Pharmacy 772-461-1402 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Enumeration Date | 2020-11-06 |
| Last Update Date | 2023-05-16 |