Healthcare Provider Details

I. General information

NPI: 1598742165
Provider Name (Legal Business Name): SANDY SCHOENBERGER RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 12/27/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 SAN PABLO RD S
JACKSONVILLE FL
32224-1865
US

IV. Provider business mailing address

4500 SAN PABLO RD S
JACKSONVILLE FL
32224-1865
US

V. Phone/Fax

Practice location:
  • Phone: 904-953-2244
  • Fax: 904-953-2274
Mailing address:
  • Phone: 904-953-2244
  • Fax: 904-953-2274

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS 26021
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: