| NPI | 1992388235 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICKI SOULE CEO 772-257-8224 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0002X Pharmacy, Clinic Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2021-05-04 |
| Last Update Date | 2022-03-22 |