| NPI | 1952483745 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DUC PHAN Pharmacy Manager 407-898-2055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: FL PH22311) |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2020-08-22 |