| NPI | 1801246251 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY ALICE ANDERSON Pharmacist 904-412-6410 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: FL PS54875) |
| Enumeration Date | 2016-06-16 |
| Last Update Date | 2016-06-16 |