Organization
MACCLENNY PHARMACY COMPANY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
INNOCENT EGBULAM OPARA RPH (PHARMACY MANAGER)
(904) 259-1116
Entity
Organization
Contact information
Practice address
1254 S 6TH ST, D-1, MACCLENNY, FL 32063-4619
(904) 259-1116
(904) 259-1118
Mailing address
5486 HIDDEN RIDGE DR, D-1, JACKSONVILLE, FL 32257-3217
(904) 259-1116
(904) 259-1118
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
Other
Enumeration date
10/13/2010
Last updated
10/14/2010
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