| NPI | 1821386475 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSSELL SHELDT President/Pharmacy Manager 850-587-4008 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: AL 113781) |
| Enumeration Date | 2011-07-18 |
| Last Update Date | 2011-11-15 |