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General NPI Number Information
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NPI Number | 1295724789
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Entity Type | Individual
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Provider Name | EPHRAIM NMN RIGGINS R.PH.,C.PH.,PHARM.D.
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Gender | Male
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Dates
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Enumeration Date | 10/17/2005
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Last Update Date | 01/10/2013
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Provider Practice Location Address
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Address Line | 6900 SOUTHPOINT DR N FOURTH FLOOR VA OUTPATIENT CLINIC
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City | JACKSONVILLE
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State | FL
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Zip | 32216-8007
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Country | US
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Telephone | 904-470-6900
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Fax | 904-470-6901
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Provider Business Mailing Address
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Address Line | 12754 SHINNECOCK CT
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City | JACKSONVILLE
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State | FL
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Zip | 32225-4692
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Country | US
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Telephone | 904-642-1906
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Fax | 904-470-6901
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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 | 15508
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License Number State | FL
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