| NPI | 1710024724 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH LOWELL BURRIS Manager 386-255-2090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0002X Pharmacy, Clinic Pharmacy (Licence: FL PH13475) |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2020-08-22 |