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NPI Code Detail

MEDICARE: FZAIPAN INC

MEDICARE: FZAIPAN INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13336S0011XSpecialty Pharmacy
2333600000XPharmacy
33336C0003XCommunity/Retail Pharmacy
43336C0004XCompounding PharmacyPH18462FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12014530OTHERPK

General Provider Information

NPI Number : 1396863478
Entity Type Code : Organization
Provider Name (Legal Business Name) : FZAIPAN INC
Provider Business Mailing Address
First Line : 6951 SAINT AUGUSTINE RD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32217-2819
Country : US
Telephone Number : 904-448-8181
Fax Number : 904-448-6662
Provider Business Practice Location Address
First Line : 6951 SAINT AUGUSTINE RD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32217-2819
Country : US
Telephone Number : 904-448-8181
Fax Number : 904-448-6662
Authorized Official
Title or Position : PHRM DIR
Name : JACOB GAVRONSKY
Credential :
Telephone Number : 904-448-8181
Provider Enumeration Date : 03/27/2007
Last Update Date : 02/20/2017

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Directions to “FZAIPAN INC ” Practice Location

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