Organization
PICH KTM CORP
Active
Other names
Medtown Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHEN OEUR RPH (PHARMACIST/PHARMACY OWNER)
(904) 551-5870
Entity
Organization
Contact information
Practice address
11643 BEACH BLVD, UNIT A, JACKSONVILLE, FL 32246
(904) 551-5870
(904) 619-6227
Mailing address
11643 BEACH BLVD, UNIT A, JACKSONVILLE, FL 32246
(904) 551-5870
(904) 619-6227
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
013879700
—
FL
Enumeration date
03/08/2019
Last updated
05/01/2023
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