Organization
FOSUYI ENTERPRISE
Active
Other names
Rite-Mart Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
FELIX OBASUYI (PHARMACY MANAGER)
(904) 353-7223
Entity
Organization
Contact information
Practice address
5312 N PEARL ST, JACKSONVILLE, FL 32208-5119
(904) 353-7223
(904) 353-7224
Mailing address
2595 WATERMILL DR, ORANGE PARK, FL 32073-1621
(904) 505-9720
(904) 693-6684
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH25006
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5702382
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
10/30/2010
Last updated
02/01/2011
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