| NPI | 1740270099 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DELAINE MCCARTY Owner 904-794-1399 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: FL PH19146) |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336C0004X Pharmacy Compounding Pharmacy | |
| Enumeration Date | 2005-10-27 |
| Last Update Date | 2017-03-29 |