| NPI | 1972172120 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTORIA CORTESE Administrative Assistant 386-310-8955 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336S0011X Pharmacy, Specialty Pharmacy |
| Enumeration Date | 2021-06-22 |
| Last Update Date | 2024-09-17 |