Organization
JAG PHARMACY AND HEALTH SERVICES
Active
Organization
JAG PHARMACY AND HEALTH SERVICES
Active
Other names
45TH STREET PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
GANIAT OLUWAMAYOWA (OWNER)
(786) 877-9297
Entity
Organization
Contact information
Practice address
5335 N MILITARY TRL STE 44, WEST PALM BEACH, FL 33407-3033
(561) 670-2001
(561) 828-8454
Mailing address
5335 N MILITARY TRL STE 44, WEST PALM BEACH, FL 33407-3033
(561) 670-2001
(561) 828-8454
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH26266
FL
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007284500
—
FL
01
—
2136375
PK
—
Enumeration date
07/24/2012
Last updated
04/20/2016
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