Organization
NORTH MAIN PHARMACY
Active
Other names
NORTH MAIN PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
SANJAY RAMCHARAN (MANAGER)
(904) 696-0265
Entity
Organization
Contact information
Practice address
12405 N MAIN ST STE 3, JACKSONVILLE, FL 32218-2609
(904) 696-0265
Mailing address
12405 NORTH MAIN STREET, SUITE 3, JACKSONVILLE, FL 32218
(904) 696-0265
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH26273
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5711177
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
07/31/2012
Last updated
02/21/2013
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