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Organization

FIRST COAST COMMUNITY DEVELOPMENT

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CHARLIE GRIFFIN (PRESIDENT)
(904) 866-7483
Entity
Organization

Contact information

Practice address
525 N NEWNAN ST, JACKSONVILLE, FL 32202-3121
(904) 379-8383
(904) 358-5618
Mailing address
4368 BOAT CLUB DR, JACKSONVILLE, FL 32277-1202
(904) 379-8383
(904) 358-5618

Taxonomy

Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
118738500
FL
Enumeration date
06/01/2023
Last updated
06/11/2025
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