Susan Dubose

NPI #1366721904 in Macclenny, Florida

Provider Information

NPI Number: 1366721904
Entity Type: Organization
Organization Name: Susan Dubose
Subpart: Yes (part of a larger organization)
Parent Organization: WINN DIXIE 0144
Primary Specialty: Pharmacy
Enumeration Date: Aug 14, 2011
Last Updated: Aug 14, 2011

Practice Location

Address: 1436 S 6TH ST
City: Macclenny
State: Florida
ZIP Code: 32063-4623
Phone: (904) 259-5868

Authorized Official

Name: MISS LONNA WILKES, PHARMD
Title: PHARMACIST
Phone: (904) 259-5868

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacy	333600000X	Primary

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