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General NPI Number Information
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NPI Number | 1669583092
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Entity Type | Organization
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Legal Business Name | IV STAT INC
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 01/11/2023
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Provider Practice Location Address
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Address Line | 533 EGLIN PKWY NE
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City | FORT WALTON BEACH
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State | FL
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Zip | 32547-2829
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Country | US
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Telephone | 850-226-8162
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Fax | 850-226-8485
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Provider Business Mailing Address
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Address Line | 533 EGLIN PKWY NE
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City | FORT WALTON BEACH
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State | FL
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Zip | 32547-2829
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Country | US
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Telephone | 850-226-8162
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Fax | 850-226-8485
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Authorized Official
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Title or Position | PHCY MGR
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Name | TRACY MCMORROW
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Credential | PHARM D
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Telephone | 850-226-8162
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | PH16174
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License Number State | FL
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