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General NPI Number Information
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NPI Number | 1346239332
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Entity Type | Organization
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Legal Business Name | FAMILY FOCUS INFUSION LLC
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Dates
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Enumeration Date | 10/21/2005
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Last Update Date | 07/16/2008
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Provider Practice Location Address
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Address Line | 4417 BEACH BLVD STE 101
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City | JACKSONVILLE
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State | FL
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Zip | 32207-4728
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Country | US
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Telephone | 904-855-0040
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Fax | 904-855-0072
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Provider Business Mailing Address
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Address Line | 4417 BEACH BLVD STE 101
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City | JACKSONVILLE
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State | FL
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Zip | 32207-4728
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Country | US
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Telephone | 904-855-0040
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Fax | 904-855-0072
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Authorized Official
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Title or Position | CEO
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Name | MS. DANA W SOPER
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Credential | RPH
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Telephone | 904-855-0040
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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 | PS 26357
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 1835N1003X
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Taxonomy Name | Nutrition Support Pharmacist
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License Number | PS 26357
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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License Number | PH 13657
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number | PH 13657
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 3336H0001X
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Taxonomy Name | Home Infusion Therapy Pharmacy
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License Number | PH 13657
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License Number State | FL
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