Organization
PICH KTM CORP
Active
Other names
Medtown Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHEN OEUR RPH (PHARMACIST/PHARMACY OWNER)
(904) 551-5870
Entity
Organization
Contact information
Practice address
11643 BEACH BLVD, UNIT A, JACKSONVILLE, FL 32246
(904) 551-5870
(904) 619-6227
Mailing address
11643 BEACH BLVD, UNIT A, JACKSONVILLE, FL 32246
(904) 551-5870
(904) 619-6227
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH28291
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
013879700
—
FL
01
—
2147617
PK
—
Enumeration date
07/09/2014
Last updated
05/01/2023
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