Provider Demographics
NPI:1821746090
Name:HARDEN-GIVENS ENTERPRISE , LLC
Entity Type:Organization
Organization Name:HARDEN-GIVENS ENTERPRISE , LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SYLVESTER
Authorized Official - Middle Name:JOSHUA
Authorized Official - Last Name:HARDEN-GIVENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-603-1654
Mailing Address - Street 1:4220 MONCRIEF RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32209-3976
Mailing Address - Country:US
Mailing Address - Phone:904-603-1654
Mailing Address - Fax:
Practice Address - Street 1:3416 MONCRIEF RD # SET101
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32209-4340
Practice Address - Country:US
Practice Address - Phone:904-900-1491
Practice Address - Fax:904-423-0426
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-16
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy