| NPI | 1821057316 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDY GRACE ALLEN VP,Pharmacy 941-877-0703 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: WV SPO550060) |
| Additional Taxonomies | 3336C0003X Pharmacy Community/Retail Pharmacy |
| 3336C0004X Pharmacy Compounding Pharmacy | |
| 3336H0001X Pharmacy Home Infusion Therapy Pharmacy | |
| 3336M0002X Pharmacy Mail Order Pharmacy | |
| 3336S0011X Pharmacy Specialty Pharmacy | |
| Enumeration Date | 2006-03-22 |
| Last Update Date | 2022-01-19 |