Healthcare Provider Details

I. General information

NPI: 1356774012
Provider Name (Legal Business Name): AYERS QUICK PERSONAL PERSCRIPTION PICK UP/ DELVERY SERVICE NC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2013
Last Update Date: 04/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1469 VALLEY GREEN DR
TALLAHASSEE FL
32303-3350
US

IV. Provider business mailing address

1469 VALLEY GREEN DR
TALLAHASSEE FL
32303-3350
US

V. Phone/Fax

Practice location:
  • Phone: 850-727-4658
  • Fax:
Mailing address:
  • Phone: 850-727-4658
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberRPT 46163,CPHT
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberRPT 465163,CPHT
License Number StateFL

VIII. Authorized Official

Name: MS. MONICA L AYERS
Title or Position: CEO
Credential: RPT 46163, CPHT
Phone: 850-727-4658