| NPI | 1952603789 |
|---|---|
| Other Name | N/A |
| Entity Type | Organization |
| Authorized Contact | CHIDOZIE SYLVANUS ENWERE Pharmacy Manager 813-381-3963 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: FL PH24971) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2010-11-30 |
| Last Update Date | 2012-11-09 |