Organization
ROBERTS SOUTH BANK PHARMACY INC
Active
Organization
ROBERTS SOUTH BANK PHARMACY INC
Active
Other names
Roberts' South Bank Pharmacy, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
GARY ROBERTS PHARMD (PRESIDENT/OWNER)
(904) 398-9660
Entity
Organization
Contact information
Practice address
1625 ATLANTIC BLVD, JACKSONVILLE, FL 32207-3318
(904) 398-9660
(904) 398-9662
Mailing address
1625 ATLANTIC BLVD, JACKSONVILLE, FL 32207-3318
(904) 398-9660
(904) 398-9662
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH24006
FL
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2119961
PK
—
Enumeration date
04/09/2009
Last updated
02/27/2017
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