NPI | 1841322005 |
---|---|
Entity Type | Organization |
Authorized Contact | CHRISTOPHER J. SMITH Cmo 386-615-5008 |
Organization Subpart ? | No |
Primary Taxonomy | 3336M0003X Pharmacy Managed Care Organization Pharmacy (Licence: FL PH23787) |
Additional Taxonomies | 333600000X Pharmacy |
Enumeration Date | 2007-03-12 |
Last Update Date | 2025-04-22 |