| NPI | 1962637496 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VALERIY KRAYTER President 386-597-7400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: FL PH24188) | |
| Enumeration Date | 2009-05-28 |
| Last Update Date | 2023-03-07 |