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General NPI Number Information
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NPI Number | 1184765299
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Entity Type | Organization
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Legal Business Name | APOTHECARE ENTERPRISES INC
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Dates
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Enumeration Date | 02/09/2007
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Last Update Date | 01/12/2009
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Provider Practice Location Address
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Address Line | 23516 COUNTY ROAD 250
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City | LIVE OAK
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State | FL
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Zip | 32060-5760
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Country | US
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Telephone | 386-658-3132
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Fax | 386-658-6432
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Provider Business Mailing Address
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Address Line | 23516 COUNTY ROAD 250
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City | LIVE OAK
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State | FL
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Zip | 32060-5760
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SEC/TREAS
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Name | BRENDA WILLIAMSON
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Credential | R PH
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Telephone | 386-658-3132
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PH0011428
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License Number State | FL
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