Organization
UNIVERSITY PHARMACY OF JACKSONVILLE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AHMED TAHER IBRAHIM (OWNER)
(904) 535-8792
Entity
Organization
Contact information
Practice address
3901 UNIVERSITY BLVD S STE 237, JACKSONVILLE, FL 32216-4390
(904) 535-8792
Mailing address
3901 UNIVERSITY BLVD S STE 237, JACKSONVILLE, FL 32216-4390
(904) 802-7177
(904) 802-7096
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PH32128
COMMUNITY RETAIL
FL
Enumeration date
05/29/2019
Last updated
01/15/2020
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