| NPI | 1902156284 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARLIN ROMAN Secretary 786-300-9150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: FL PH26326) |
| Additional Taxonomies | 3336S0011X Pharmacy Specialty Pharmacy (Licence: FL PH26327) |
| Enumeration Date | 2012-09-14 |
| Last Update Date | 2012-09-14 |