Organization
THE WATTS CO OF MARIANNA INC
Active
Other names
WACO DRUGS AND GIFTS
Organization subpart
No
Provider details
NPI number
Authorized official
JIM WATTS (PRESIDENT)
(850) 482-5781
Entity
Organization
Contact information
Practice address
4154 LAFAYETTE ST STE G, ST G, MARIANNA, FL 32446-5655
(850) 482-5781
(850) 482-6880
Mailing address
4154 LAFAYETTE ST STE G, ST G, MARIANNA, FL 32446-5655
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
PH3054
FL
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1014391
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
101755100
—
FL
Enumeration date
09/21/2006
Last updated
08/24/2010
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