Organization
FLEMING ISLAND PHARMACY LLC
Active
Other names
Fleming Island Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MIKHIL JOSEPH PHARMD. (PHARMACIST/OWNER)
(904) 718-7352
Entity
Organization
Contact information
Practice address
2349 VILLAGE SQUARE PKWY STE 106, FLEMING ISLAND, FL 32003-4319
(904) 644-8233
(904) 458-4444
Mailing address
2349 VILLAGE SQUARE PKWY STE 106, SUITE# 106, FLEMING ISLAND, FL 32003-4319
(904) 644-8233
(904) 458-4444
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH27325
FL
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
013196400
—
FL
01
—
2147634
PK
—
Enumeration date
09/03/2014
Last updated
02/20/2017
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