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General NPI Number Information
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NPI Number | 1346473915
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Entity Type | Organization
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Legal Business Name | MANFY, INC
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Dates
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Enumeration Date | 08/31/2009
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Last Update Date | 08/31/2009
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Provider Practice Location Address
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Address Line | 960 BEAVER CREEK WAY
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City | TALLAHASSEE
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State | FL
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Zip | 32301-7313
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Country | US
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Telephone | 727-457-7539
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Fax |
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Provider Business Mailing Address
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Address Line | 2303 W 15TH ST # D
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City | PANAMA CITY
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State | FL
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Zip | 32401-1500
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Country | US
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Telephone | 850-785-0700
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ISMAIL MOHAMED
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Credential |
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Telephone | 727-457-7539
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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 | PS36447
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License Number State | FL
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