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General NPI Number Information
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NPI Number | 1487982765
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Entity Type | Organization
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Legal Business Name | WATSON PHARMACY INC
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Dates
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Enumeration Date | 11/25/2009
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Last Update Date | 02/03/2010
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Provider Practice Location Address
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Address Line | 8058 OLD KINGS RD S
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City | JACKSONVILLE
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State | FL
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Zip | 32217-4102
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Country | US
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Telephone | 904-619-5523
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Fax | 904-619-5527
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Provider Business Mailing Address
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Address Line | PO BOX 24569
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City | JACKSONVILLE
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State | FL
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Zip | 32241-4569
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Country | US
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Telephone | 904-619-5523
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Fax | 904-619-5527
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Authorized Official
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Title or Position | PRESIDENT/PHARMACY MANAGER
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Name | FRANK GAZALEH
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Credential |
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Telephone | 904-504-2100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PH24358
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License Number State | FL
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