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General NPI Number Information
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NPI Number | 1285351312
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Entity Type | Individual
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Provider Name | NABAT JACOBS
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Gender | Female
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Dates
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Enumeration Date | 10/19/2022
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Last Update Date | 10/19/2022
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Provider Practice Location Address
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Address Line | 1995 N STATE ROAD 19
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City | EUSTIS
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State | FL
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Zip | 32726-6728
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Country | US
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Telephone | 352-589-1330
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Fax |
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Provider Business Mailing Address
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Address Line | 1 CVS DR
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City | WOONSOCKET
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State | RI
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Zip | 02895-6195
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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 |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS51990
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License Number State | FL
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