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General NPI Number Information
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NPI Number | 1235559469
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Entity Type | Organization
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Legal Business Name | SETON PHARMACY INC
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Dates
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Enumeration Date | 04/28/2014
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Last Update Date | 07/07/2015
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Provider Practice Location Address
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Address Line | 1760 EDGEWOOD AVE W STE C
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City | JACKSONVILLE
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State | FL
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Zip | 32208-7209
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Country | US
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Telephone | 904-450-8787
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Fax | 904-924-1145
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Provider Business Mailing Address
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Address Line | 1760 EDGEWOOD AVE W SUITE C
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City | JACKSONVILLE
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State | FL
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Zip | 32208-7209
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Country | US
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Telephone | 904-450-8787
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Fax | 904-924-1145
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Authorized Official
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Title or Position | PHARMACY DIRECTOR,AO
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Name | CHARZETTA JAMES
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Credential |
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Telephone | 904-450-8787
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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 | PH28043
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License Number State | FL
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