| NPI | 1902220932 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEIGH A MATHES Pharmacy Manager 850-381-1433 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: AL 114292) |
| Enumeration Date | 2014-02-11 |
| Last Update Date | 2022-05-16 |