Provider Demographics
NPI:1811294234
Name:AZOF ENTERPRISES INC
Entity type:Organization
Organization Name:AZOF ENTERPRISES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AZUBIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:OFOKANSI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-233-6550
Mailing Address - Street 1:1936 SE PORT ST LUCIE BLVD
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34952-5509
Mailing Address - Country:US
Mailing Address - Phone:772-446-9284
Mailing Address - Fax:772-807-1297
Practice Address - Street 1:1936 SE PORT ST LUCIE BLVD
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-5509
Practice Address - Country:US
Practice Address - Phone:772-446-9284
Practice Address - Fax:772-807-1297
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-21
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH25218332B00000X, 333600000X
FLPS344343336C0003X, 3336C0004X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy