| NPI | 1942240379 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH POPE Contract Administrator 863-688-1188 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy (Licence: GA PHRE007890) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2007-10-02 |