Organization
INTEGRATED COMMUNITY ONCOLOGY NETWORK,LLC
Active
Other names
ICON Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT PHELAN (EXECUTIVE DIRECTOR)
(904) 363-7442
Entity
Organization
Contact information
Practice address
9143 PHILIPS HWY, STE 570, JACKSONVILLE, FL 32256-1348
(904) 519-2720
(904) 519-2721
Mailing address
9143 PHILIPS HWY, STE 560, JACKSONVILLE, FL 32256-1348
(904) 363-2113
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
031184700
—
FL
Enumeration date
10/31/2005
Last updated
11/11/2011
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