Organization
PRAETORIAN RX LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH DEWAYNE LANIER PHARMD (PRESIDENT)
(813) 929-0778
Entity
Organization
Contact information
Practice address
20429 AUTUMN FERN AVE, TAMPA, FL 33647-2967
(186) 623-2877
Mailing address
20429 AUTUMN FERN AVE, TAMPA, FL 33647-2967
(186) 623-2877
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
03/19/2012
Last updated
03/19/2012
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