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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