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General NPI Number Information
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NPI Number | 1184790537
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Entity Type | Organization
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Legal Business Name | ABU-SEIFEN CORP.
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Dates
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Enumeration Date | 11/28/2006
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Last Update Date | 02/04/2008
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Provider Practice Location Address
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Address Line | 158 RIDGEWOOD AVE
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City | HOLLY HILL
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State | FL
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Zip | 32117-5028
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Country | US
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Telephone | 386-238-3500
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Fax | 386-238-8855
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Provider Business Mailing Address
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Address Line | 158 RIDGEWOOD AVE
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City | HOLLY HILL
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State | FL
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Zip | 32117-5028
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Country | US
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Telephone | 386-238-3500
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Fax | 386-238-8855
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Authorized Official
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Title or Position | PHARMACY MANAGER
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Name | MRS. EVETTE A SAAD
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Credential | PHARMACIST
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Telephone | 386-238-3500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PH20022
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License Number State | FL
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