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General NPI Number Information
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NPI Number | 1730479536
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Entity Type | Organization
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Legal Business Name | WELCOME PHARMACY CO
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Dates
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Enumeration Date | 04/13/2011
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Last Update Date | 05/19/2011
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Provider Practice Location Address
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Address Line | 9825-36 SAN JOSE BLVD
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City | JACKSONVILLE
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State | FL
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Zip | 32257
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Country | US
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Telephone | 904-288-0030
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Fax | 904-288-0039
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Provider Business Mailing Address
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Address Line | 9825-36 SAN JOSE BLVD.,
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City | JACKSONVILLE
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State | FL
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Zip | 32257
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Country | US
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Telephone | 904-288-0030
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Fax | 904-288-0039
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Authorized Official
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Title or Position | PHARMACIST
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Name | HAVNICCA WELCOME
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Credential |
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Telephone | 904-403-7495
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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 | PH25398
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License Number State | FL
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