| NPI | 1881655330 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD KUNZWEILER Manager 772-398-5870 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: FL PH28876) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 333600000X Pharmacy | |
| 3336M0002X Pharmacy Mail Order Pharmacy | |
| 3336S0011X Pharmacy Specialty Pharmacy | |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2025-06-03 |