# ICON PHARMACY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1841304730
- **Authorized official:** RUBEN GARZON RPH (PHARMACIST)
- **Authorized official phone:** (407) 649-8050

## Contact information

- **Practice address:** 300 E CHURCH ST, ORLANDO, FL 32801-3544
- **Practice address phone:** (407) 649-8050
- **Practice address fax:** (407) 649-8051
- **Mailing address:** 1371 W RAHN RD, DAYTON, OH 45459-1431

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336I0012X | Institutional Pharmacy | PH21554 | FL | Yes |

## Other

- **Enumeration date:** 08/18/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1015242 | OTHER ID NUMBER-COMMERCIAL NUMBER | — |