| NPI | 1811294234 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AZUBIKE OFOKANSI Pharmacy Manager 772-233-6550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: FL ps34434) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: FL ph25218) |
| 333600000X Pharmacy (Licence: FL ph25218) | |
| Enumeration Date | 2011-02-21 |
| Last Update Date | 2016-10-20 |