Provider Demographics
NPI:1497134449
Name:FULL HEALTH PHARMACY
Entity Type:Organization
Organization Name:FULL HEALTH PHARMACY
Other - Org Name:N/A
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:CHUKWUEMEKA
Authorized Official - Last Name:OSUJI
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:786-703-4652
Mailing Address - Street 1:637 NE 125TH ST
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33161-5503
Mailing Address - Country:US
Mailing Address - Phone:786-703-4652
Mailing Address - Fax:786-703-8761
Practice Address - Street 1:637 NE 125TH ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33161-5503
Practice Address - Country:US
Practice Address - Phone:786-703-4652
Practice Address - Fax:786-703-8761
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-22
Last Update Date:2015-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH29121333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy