Provider Demographics
NPI:1588098677
Name:CHAPMAN, MACKENZIE KECK (PHARMD, RPH)
Entity type:Individual
Prefix:MS
First Name:MACKENZIE
Middle Name:KECK
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:777 N MARKET ST
Mailing Address - Street 2:PHARMACY
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32202-2740
Mailing Address - Country:US
Mailing Address - Phone:904-632-0844
Mailing Address - Fax:
Practice Address - Street 1:777 N MARKET ST
Practice Address - Street 2:PHARMACY
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32202-2740
Practice Address - Country:US
Practice Address - Phone:904-632-0844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-26
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS50882183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist