Individual
ALEX CHACKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
7305 BROAD ST, BROOKSVILLE, FL 34601-3158
(352) 796-6221
Mailing address
7305 BROAD ST, BROOKSVILLE, FL 34601-3158
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PS34784
FL
Other
Enumeration date
10/30/2020
Last updated
10/30/2020
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