| NPI | 1821865056 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUMANTH KUMAR EDARA President 904-779-6990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Additional Taxonomies | 3336M0002X Pharmacy, Mail Order Pharmacy |
| Enumeration Date | 2023-12-07 |
| Last Update Date | 2023-12-29 |