Healthcare Provider Details

I. General information

NPI: 1093099434
Provider Name (Legal Business Name): AMBER NICOLE WOJACK PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2011
Last Update Date: 10/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

399 N CONGRESS AVE
BOYNTON BEACH FL
33426-3415
US

IV. Provider business mailing address

5265 CHELAN CV
LAKE WORTH FL
33467-5514
US

V. Phone/Fax

Practice location:
  • Phone: 561-736-3558
  • Fax:
Mailing address:
  • Phone: 561-596-4504
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS46805
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: