Organization
MEDIKON LLC
Active
Other names
Duval Pharmacy 201
Organization subpart
No
Provider details
NPI number
Authorized official
NISHANT PATEL (PHARMACY MANAGER)
(904) 900-7700
Entity
Organization
Contact information
Practice address
7077 NORMANDY BLVD, SUITE 5, JACKSONVILLE, FL 32205-6279
(904) 900-7700
(904) 551-0794
Mailing address
7077 NORMANDY BLVD, SUITE 5, JACKSONVILLE, FL 32205-6279
(904) 900-7700
(904) 551-0794
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH26435
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008148500
—
FL
01
—
PH26435
FLORIDA BOARD OF PHARMACY
FL
Enumeration date
10/20/2012
Last updated
04/12/2018
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