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General NPI Number Information
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NPI Number | 1821746090
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Entity Type | Organization
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Legal Business Name | HARDEN-GIVENS ENTERPRISE , LLC
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Dates
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Enumeration Date | 03/16/2022
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Last Update Date | 03/16/2022
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Provider Practice Location Address
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Address Line | 3416 MONCRIEF RD # SET101
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City | JACKSONVILLE
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State | FL
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Zip | 32209-4340
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Country | US
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Telephone | 904-900-1491
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Fax | 904-423-0426
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Provider Business Mailing Address
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Address Line | 4220 MONCRIEF RD
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City | JACKSONVILLE
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State | FL
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Zip | 32209-3976
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Country | US
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Telephone | 904-603-1654
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SYLVESTER JOSHUA HARDEN-GIVENS
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Credential |
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Telephone | 904-603-1654
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State |
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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 |
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License Number State |
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