Organization
MANFY INC
Active
Other names
Medicine Shoppe #1864
Organization subpart
No
Provider details
NPI number
Authorized official
ISMAIL MOHAMED (PRESIDENT)
(727) 457-7539
Entity
Organization
Contact information
Practice address
2303 W 15TH ST STE D, PANAMA CITY, FL 32401-1500
(850) 785-0700
(850) 785-0747
Mailing address
2303 W 15TH ST STE D, PANAMA CITY, FL 32401-1500
(850) 785-0700
(850) 785-0747
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH24235
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1014517
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
02/21/2007
Last updated
04/12/2011
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