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General NPI Number Information
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NPI Number | 1326174442
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Entity Type | Individual
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Provider Name | DR. CHO NKENGLA
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Gender | Male
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Dates
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Enumeration Date | 02/25/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5207 NORMANDY BLVD WINN-DIXIE PHARMACY
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City | JACKSONVILLE
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State | FL
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Zip | 32205-4827
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Country | US
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Telephone | 904-786-4639
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Fax |
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Provider Business Mailing Address
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Address Line | 8787 SOUTHSIDE BLVD APT 3710
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City | JACKSONVILLE
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State | FL
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Zip | 32256-3602
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Country | US
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Telephone | 630-664-5969
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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 | PS39850
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License Number State | FL
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