Organization
PACIFICO NATIONAL II INC
Active
Other names
AmEx Pharma Lab
Organization subpart
No
Provider details
NPI number
Authorized official
MARK SANGREE (PRESIDENT)
(561) 445-2356
Entity
Organization
Contact information
Practice address
2275 S BABCOCK ST, MELBOURNE, FL 32901
(800) 770-2990
(800) 992-1322
Mailing address
2275 S BABCOCK ST, MELBOURNE, FL 32901-5305
(800) 770-2990
(800) 992-1322
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AS032
MEDICARE-FIRST COAST SERVICE OPTIONS, INC.
FL
Enumeration date
06/17/2006
Last updated
06/06/2018
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