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Organization

QUALITY SPECIALTY PHARMACY OF JACKSONVILLE INC

Active
Other names
Quality Specialty Pharmacy of Jacksonville
Organization subpart
No

Provider details

NPI number
Authorized official
SOFIA AXEN (OWNER)
(718) 648-2952
Entity
Organization

Contact information

Practice address
6680 POWERS AVE, UNIT 110, JACKSONVILLE, FL 32217-2889
(904) 365-5500
(904) 365-5501
Mailing address
P.O. BOX 16159, TEMPLE TERRACE, FL 33682
(904) 365-5500
(904) 365-5501

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
PH25472
FL
3336S0011X
Specialty Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004444200
FL
01
2131100
PK
Enumeration date
08/08/2011
Last updated
10/26/2016
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