Organization
NORTH FLORIDA PHARMACY OF MAYO, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICKY S NOLING PHARM.D. (CO-OWNER/MANAGER)
(386) 294-3777
Entity
Organization
Contact information
Practice address
229 WEST MAIN STREET/ BOX 1510, MAYO, FL 32066
(386) 294-3777
Mailing address
229 WEST MAIN STREET, PO BOX 1510, MAYO, FL 32066
(386) 294-3777
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
026343500
—
FL
05
—
026343501
—
FL
01
—
P8389
BLUE CROSS/BLUE SHIELD
FL
Enumeration date
07/21/2006
Last updated
05/12/2008
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