| NPI | 1881698355 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES MELANCON Vice President 917-449-6939 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: FL PH0015110) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2005-06-13 |
| Last Update Date | 2011-09-13 |