| NPI | 1790503548 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANA LEIGH WEATHERBY Pharmacy Manager 407-357-2618 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Additional Taxonomies | 3336M0002X Pharmacy Mail Order Pharmacy |
| Enumeration Date | 2024-10-01 |
| Last Update Date | 2024-10-01 |