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General NPI Number Information
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NPI Number | 1851751663
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Entity Type | Organization
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Legal Business Name | WAMU LLC
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Dates
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Enumeration Date | 03/07/2016
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Last Update Date | 01/06/2021
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Provider Practice Location Address
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Address Line | 85 CYPRESS POINT PKWY UNIT B
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City | PALM COAST
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State | FL
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Zip | 32164-8455
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Country | US
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Telephone | 386-447-8944
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Fax | 386-447-8940
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Provider Business Mailing Address
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Address Line | 85 CYPRESS POINT PKWY UNIT B
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City | PALM COAST
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State | FL
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Zip | 32164-8455
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Country | US
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Telephone | 386-447-8944
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Fax | 386-447-8940
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Authorized Official
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Title or Position | CEO/PHARMACIST/CO-OWNER
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Name | DR. JOSEPH SHOYOYE
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Credential | PHARND
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Telephone | 386-447-8944
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | PH30024
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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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 | PH30024
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License Number State | FL
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