Provider Demographics
NPI:1538563580
Name:FLORIDA A AND M UNIVERSITY COLLEGE OF PHARMACY
Entity type:Organization
Organization Name:FLORIDA A AND M UNIVERSITY COLLEGE OF PHARMACY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIVISION DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:S
Authorized Official - Last Name:EMANUEL
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:904-391-3901
Mailing Address - Street 1:2050 ART MUSEUM DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32207-2595
Mailing Address - Country:US
Mailing Address - Phone:904-391-3900
Mailing Address - Fax:904-391-3915
Practice Address - Street 1:2050 ART MUSEUM DR
Practice Address - Street 2:SUITE 200
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-2595
Practice Address - Country:US
Practice Address - Phone:904-391-3900
Practice Address - Fax:904-391-3915
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-20
Last Update Date:2014-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL13024333600000X
FLPU379333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy