| NPI | 1871894048 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY CHEN Administrator 305-621-0023 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: FL ME66878) |
| Enumeration Date | 2010-11-04 |
| Last Update Date | 2012-07-18 |