Organization
WAAS DRUG STORE INC
Active
Other names
WAAS DRUG STORE
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES PARKER RPH (PRES)
(904) 261-3171
Entity
Organization
Contact information
Practice address
1551 S 14TH ST, STE 1, FERNANDINA BEACH, FL 32034-1930
(904) 261-3171
(904) 321-0685
Mailing address
PO BOX 518, FERNANDINA BEACH, FL 32035-0518
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH1804
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102064100
—
FL
01
—
2004149
PK
—
Enumeration date
12/04/2006
Last updated
09/29/2016
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