Organization
DAYLAN INC
Active
Other names
His Grace Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
BOLAJI ADISA (OWNER)
(407) 963-1108
Entity
Organization
Contact information
Practice address
600 E ALTAMONTE DR, SUITE 1400, ALTAMONTE SPRINGS, FL 32701-4815
(407) 790-4863
(407) 790-4864
Mailing address
600 E ALTAMONTE DR, ALTAMONTE SPRINGS, FL 32701-4815
(407) 790-4863
(407) 790-4864
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH24483
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2123958
PK
—
Enumeration date
02/26/2010
Last updated
02/20/2017
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