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General NPI Number Information
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NPI Number | 1487674271
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Entity Type | Organization
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Legal Business Name | NORTH FLORIDA PHARMACY OF MAYO, INC
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Dates
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Enumeration Date | 07/21/2006
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Last Update Date | 05/12/2008
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Provider Practice Location Address
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Address Line | 229 WEST MAIN STREET/ BOX 1510
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City | MAYO
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State | FL
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Zip | 32066
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Country | US
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Telephone | 386-294-3777
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Fax |
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Provider Business Mailing Address
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Address Line | 229 WEST MAIN STREET PO BOX 1510
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City | MAYO
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State | FL
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Zip | 32066
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Country | US
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Telephone | 386-294-3777
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Fax |
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Authorized Official
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Title or Position | CO-OWNER/MANAGER
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Name | VICKY S NOLING
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Credential | PHARM.D.
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Telephone | 386-294-3777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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