Organization
ROCK 3
Active
Other names
Mims Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN ONI (PHARMACY MANAGER)
(850) 292-1917
Entity
Organization
Contact information
Practice address
2448 US HIGHWAY 1, MIMS, FL 32754-3854
(321) 567-4919
Mailing address
PO BOX 410917, MELBOURNE, FL 32941-0917
(850) 292-1917
(321) 259-3330
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH24391
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002203800
—
FL
01
—
2123396
PK
—
Enumeration date
01/12/2010
Last updated
04/22/2016
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