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General NPI Number Information
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NPI Number | 1518465459
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Entity Type | Organization
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Legal Business Name | VERDANT ANALYTICS, LLC
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Dates
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Enumeration Date | 01/25/2018
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Last Update Date | 01/25/2018
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Provider Practice Location Address
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Address Line | 5991 A1A S
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City | ST AUGUSTINE
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State | FL
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Zip | 32080-7017
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Country | US
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Telephone | 904-679-5931
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Fax | 844-272-1465
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Provider Business Mailing Address
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Address Line | 5991 A1A S
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City | ST AUGUSTINE
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State | FL
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Zip | 32080-7017
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Country | US
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Telephone | 904-679-5931
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Fax | 844-272-1465
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Authorized Official
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Title or Position | OWNER
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Name | DR. NAOMI BETH CONANT
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Credential | PHARM.D.
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Telephone | 904-679-5931
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number | PH29473
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | PH29473
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License Number State | FL
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