| NPI | 1831522234 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONYA SHACKELFORD President 813-304-2221 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: NC 11607) |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336C0004X Pharmacy Compounding Pharmacy | |
| 3336S0011X Pharmacy Specialty Pharmacy | |
| Enumeration Date | 2013-08-21 |
| Last Update Date | 2020-07-24 |