| NPI | 1952611329 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BHUMIN PATEL Pharmacy Manager 941-773-4460 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: FL PH24996) |
| Additional Taxonomies | 3336C0004X Pharmacy Compounding Pharmacy |
| 3336L0003X Pharmacy Long Term Care Pharmacy | |
| Enumeration Date | 2010-10-19 |
| Last Update Date | 2019-06-17 |