Organization
GONCAN, INC
Active
Other names
SOUTH BAY PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GODWIN A NWAOBI R.PH (PHARMACIST MANAGER)
(561) 992-9220
Entity
Organization
Contact information
Practice address
155 US HIGHWAY 27 S, SOUTH BAY, FL 33493-2213
(561) 992-9220
(561) 992-9330
Mailing address
7050 SW 27TH ST, MIRAMAR, FL 33023-3757
(954) 962-2310
(561) 992-9330
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH 13892
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103475800
—
FL
Enumeration date
07/20/2006
Last updated
08/01/2007
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