| NPI | 1669799425 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN RAYMOND DOBBS Manager 239-290-7230 |
| Organization Subpart ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS38239) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS45662) |
| Enumeration Date | 2010-05-03 |
| Last Update Date | 2010-05-03 |