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Organization

FLORIDA DEPARTMENT OF VETERANS' AFFAIRS

Active
Parent organization
FLORIDA DEPARTMENT OF VETERANS' AFFAIRS
Other names
Ardie R. Copas State Veterans Nursing Home - Pharmacy
Organization subpart
Yes

Provider details

NPI number
Legal business name
FLORIDA DEPARTMENT OF VETERANS' AFFAIRS
Authorized official
CONNIE SUE TOLLEY (DIRECTOR FDVA HOMES)
(727) 518-3203
Entity
Organization

Contact information

Practice address
13000 SE TRADITION PARKWAY, PORT ST. LUICE, FL 34987
(772) 241-6132
Mailing address
13000 SE TRADITION PARKWAY, PORT ST. LUICE, FL 34987
(772) 241-6132

Taxonomy

Speciality
Code
Description
License number
State
332100000X
Department of Veterans Affairs (VA) Pharmacy
Primary

Other

Enumeration date
04/12/2022
Last updated
04/12/2022
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