Registry details
Type
Individual
Primary specialty
Pharmacist
Enumerated
Nov 30, 2020
License(s)
PS61209 (FL)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 1819 W TENNESSEE ST | Tallahassee, FL 32304-3356 | 850-576-0147 |
| MAILING | 1412 N M L KING JR BLVD | Tallahassee, FL 32303-5413 | 321-444-8242 |
Watch this provider
Get a webhook/email the day this provider is added to the OIG-LEIE exclusion list or appears in an FDA enforcement action.