Organization
GONCAN INC
Active
Other names
TRINITY PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
GODWIN NWAOBI (PRESCRIPTION DEPT.MANAGER)
(772) 882-4785
Entity
Organization
Contact information
Practice address
800 VIRGINIA AVE, SUITE #33, FORT PIERCE, FL 34982-5829
(772) 882-4785
(772) 519-9982
Mailing address
800 VIRGINIA AVE, SUITE #33, FORT PIERCE, FL 34982-5829
(772) 882-4785
(772) 519-9982
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH24941
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003799300
—
FL
01
—
5702231
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
10/21/2010
Last updated
02/01/2013
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