Provider Demographics
NPI:1518465459
Name:VERDANT ANALYTICS, LLC
Entity Type:Organization
Organization Name:VERDANT ANALYTICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NAOMI
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:CONANT
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:904-679-5931
Mailing Address - Street 1:5991 A1A S
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32080-7017
Mailing Address - Country:US
Mailing Address - Phone:904-679-5931
Mailing Address - Fax:844-272-1465
Practice Address - Street 1:5991 A1A S
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32080-7017
Practice Address - Country:US
Practice Address - Phone:904-679-5931
Practice Address - Fax:844-272-1465
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-25
Last Update Date:2018-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH29473333600000X, 3336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy