| NPI | 1831102763 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEMORRIS PRIER Dirtr Of Phcy 904-253-2461 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0002X Pharmacy Clinic Pharmacy (Licence: FL PH19420) |
| Additional Taxonomies | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2014-07-29 |