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NPI Code Detail

MEDICARE: JOANNA MATHENEY RPH

MEDICARE:   JOANNA  MATHENEY  RPH
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
1183500000XPharmacistPS29596FL

General Provider Information

NPI Number : 1477582716
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOANNA MATHENEY RPH
Provider Business Mailing Address
First Line : 1370 13TH AVE S
Second Line : SUITE 117
City : JACKSONVILLE BEACH
State : FL
Zip : 32250-3230
Country : US
Telephone Number : 904-390-3601
Fax Number : 904-858-3053
Provider Business Practice Location Address
First Line : 1370 13TH AVE S
Second Line : SUITE 117
City : JACKSONVILLE BEACH
State : FL
Zip : 32250-3230
Country : US
Telephone Number : 904-390-3601
Fax Number : 904-858-3053
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2006
Last Update Date : 01/06/2010

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Directions to “ JOANNA MATHENEY RPH” Practice Location

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