| NPI | 1851846208 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDEEP MATHOW Member 407-617-6059 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: TX 31356) |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336C0003X Pharmacy Community/Retail Pharmacy | |
| 3336C0004X Pharmacy Compounding Pharmacy | |
| Enumeration Date | 2016-08-15 |
| Last Update Date | 2018-07-17 |