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General NPI Number Information
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NPI Number | 1508870395
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Entity Type | Organization
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Legal Business Name | FLA A AND M UNIVERSITY STUDENT HLTH PHCY
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Dates
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Enumeration Date | 07/28/2006
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Last Update Date | 09/12/2007
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Provider Practice Location Address
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Address Line | RM 113 STUDENT HEALTH SERVICES FOOTE HILVER ADM BUILDING
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City | TALLAHASSEE
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State | FL
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Zip | 32307
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Country | US
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Telephone | 850-412-7881
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Fax | 850-599-3742
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Provider Business Mailing Address
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Address Line | RM 113 STUDENT HEALTH SERVICES FOOTE HILVER ADM BUILDING
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City | TALLAHASSEE
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State | FL
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Zip | 32307
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHARMACY MANAGER
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Name | MARTHA ROSS
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Credential |
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Telephone | 850-412-7881
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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 | PH18062
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License Number State | FL
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