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General NPI Number Information
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NPI Number | 1811294234
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Entity Type | Organization
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Legal Business Name | AZOF ENTERPRISES INC
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Dates
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Enumeration Date | 02/21/2011
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Last Update Date | 10/20/2016
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Provider Practice Location Address
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Address Line | 1936 SE PORT ST LUCIE BLVD
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City | PORT ST LUCIE
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State | FL
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Zip | 34952-5509
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Country | US
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Telephone | 772-446-9284
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Fax | 772-807-1297
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Provider Business Mailing Address
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Address Line | 1936 SE PORT ST LUCIE BLVD
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City | PORT ST LUCIE
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State | FL
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Zip | 34952-5509
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Country | US
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Telephone | 772-446-9284
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Fax | 772-807-1297
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Authorized Official
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Title or Position | PHARMACY MANAGER
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Name | AZUBIKE OFOKANSI
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Credential |
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Telephone | 772-233-6550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | PH25218
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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 | PH25218
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PS34434
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License Number State | FL
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