| NPI | 1912015116 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS MOSS Owner 941-795-4727 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy, Compounding Pharmacy (Licence: FL PH 17734) |
| Enumeration Date | 2006-08-28 |
| Last Update Date | 2020-08-22 |