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General NPI Number Information
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NPI Number | 1245415801
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Entity Type | Organization
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Legal Business Name | KNIGHT AIDE
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Dates
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Enumeration Date | 01/02/2008
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Last Update Date | 12/08/2016
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Provider Practice Location Address
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Address Line | 4000 CENTRAL FLORIDA BLVD BLDG 137 STE K
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City | ORLANDO
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State | FL
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Zip | 32816-8005
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Country | US
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Telephone | 407-882-0600
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Fax | 407-882-0603
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Provider Business Mailing Address
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Address Line | 4000 CENTRAL FLORIDA BLVD BLDG 137 STE K
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City | ORLANDO
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State | FL
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Zip | 32816-8005
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Country | US
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Telephone | 407-882-0600
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Fax | 407-882-0603
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Authorized Official
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Title or Position | PHCY DIRECTOR
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Name | SHERYL GAMBLE
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Credential | RPH
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Telephone | 407-823-6084
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | PH23039
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License Number State | FL
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