| NPI | 1851506091 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY KACZMAREK Controller 407-351-7080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: RI 614, 614.1) |
| Additional Taxonomies | 3336C0002X Pharmacy, Clinic Pharmacy (Licence: RI CMC00033) |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2007-12-03 |