Marietta Pharmacy

LBN: Marietta Pharmacy Llc
Marietta Pharmacy is an health care organization with primary practice located at 8299 W Beaver St Ste 5 , Jacksonville FL 32220-2315. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Long Term Care Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Marietta Pharmacy Llc can be contacted via phone (904) 999-4884, or through Patel, Hanesh via phone (904) 999-4884.

Contact Information

Primary practice address
8299 W Beaver St Ste 5 Jacksonville FL 32220-2315
Phone: (904) 999-4884
Fax: (904) 999-4883
Website:
Map and Directions
Authorized official contact:
Name: Patel, Hanesh
Phone: (904) 999-4884

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X PH26285 Florida
Suppliers / Long Term Care Pharmacy 3336L0003X

Profile Details

NPI number 1912253774
LBN Legal business name Marietta Pharmacy Llc
DBA Doing business as Marietta Pharmacy
Authorized official Patel, Hanesh
Entity Organization
Organization subpart 1 No
Enumeration date Jul 31st, 2012
Last updated Feb 24th, 2022 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912253774 NPPES
Florida MEDICAID 007212200
Florida Other 5711189

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