| NPI | 1851750178 |
|---|---|
| Doing Business As | SPACE COAST COMMUNITY PHARMACY |
| Entity Type | Organization |
| Authorized Contact | TRACI MITCHELL Owner 321-636-2275 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: FL PH29873) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: FL PH29873) |
| 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: FL PH29873) | |
| 333600000X Pharmacy | |
| Enumeration Date | 2016-02-15 |
| Last Update Date | 2020-01-28 |