| Organization Name: | WIN-DIXIE PHARMACY |
| NPI Number: | 1740306893 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | VICTOR OSEI-KOFI (PHARMACY MANAGER) |
| Mailing Address: | 11926 Grovewood Ave Thonotosassa |
| State: | FL US |
| Postal Code: | 335922848 |
| Phone Number: | 8139860788 |
| Fax Number: | 8139869607 |
| NPI Enumeration Date: | 03/21/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 320700000X |
| License Number: | 380100106110506 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Residential Treatment Facilities |
| Taxonomy Classification: | Residential Treatment Facility, Physical Disabilities |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |