| NPI | 1952587172 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CICELY EASON Executive Administrator 561-789-4911 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: FL ME71405) |
| Enumeration Date | 2008-01-17 |
| Last Update Date | 2008-05-07 |