Organization
MOULTRIE PHARMACY INC
Active
Parent organization
MOULTRIE PHARMACY INC
Other names
MOULTRIE PHARMACY LTC
Organization subpart
Yes
Provider details
NPI number
Legal business name
MOULTRIE PHARMACY INC
Authorized official
KEVIN JOSEPH DUANE (OWNER)
(904) 765-3531
Entity
Organization
Contact information
Practice address
3690 US HIGHWAY 1 S, ST AUGUSTINE, FL 32086-6498
(904) 794-1399
Mailing address
7707 MERRILL RD UNIT 8664, JACKSONVILLE, FL 32239-7728
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Enumeration date
11/24/2025
Last updated
11/24/2025
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