Healthcare Provider Details

I. General information

NPI: 1437292349
Provider Name (Legal Business Name): ALOY IKECHUKWU ADIGWEME RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5134 FIRESTONE RD
JACKSONVILLE FL
32210-6722
US

IV. Provider business mailing address

PO BOX 43364
JACKSONVILLE FL
32203-3364
US

V. Phone/Fax

Practice location:
  • Phone: 904-777-9911
  • Fax: 904-680-0695
Mailing address:
  • Phone: 904-260-2792
  • Fax: 904-680-0695

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS0020649
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License NumberPS0020649
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: