| NPI | 1891205696 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VONDALYN D WRIGHT Pharmacist 813-447-9639 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: FL PH30965) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2017-10-05 |
| Last Update Date | 2023-11-21 |