Organization
WEISE PRESCRIPTION SHOP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GILBERT NELSON WEISE JR. RPH (PHARMACIST MANAGER)
(904) 388-1564
Entity
Organization
Contact information
Practice address
4343 COLONIAL AVENUE, JACKSONVILLE, FL 32210-3393
(904) 388-1564
(904) 384-0569
Mailing address
4343 COLONIAL AVENUE, JACKSONVILLE, FL 32210-3393
(904) 388-1564
(904) 384-0569
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PH520
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1012234
NABP
—
Enumeration date
11/22/2006
Last updated
08/22/2020
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