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Organization

FLORIDA DEPARTMENT OF CHILDREN AND FAMILIES

Active
Other names
FLORIDA STATE HOSPITAL
Organization subpart
No

Provider details

NPI number
Authorized official
TONJA MCELVIN PHARMD (DIRECTOR OF PHARMACY)
(850) 663-7675
Entity
Organization

Contact information

Practice address
100 N MAIN ST BLDG 1235, CHATTAHOOCHEE, FL 32324-1107
(850) 663-7675
(850) 663-7385
Mailing address
PO BOX 1000, CHATTAHOOCHEE, FL 32324-1000
(850) 663-7675
(850) 663-7385

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
3336I0012X
Institutional Pharmacy
PH6234
FL
3336L0003X
Long Term Care Pharmacy
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
014463700
FL
01
2005839
PK
Enumeration date
06/22/2006
Last updated
07/30/2019
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