THE APOTHECARY AT MEMORIAL (NPI# 1508966649) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508966649 |
| Entity Type | Organization |
| Organization Name | THE APOTHECARY AT MEMORIAL |
| Practice Address |
3627 University Blvd S Jacksonville FL 32216-4230 |
| Practice Telephone | 9047026171 |
| Practice Fax Number | 9047026004 |
| Mailing Telephone | 9047026171 |
| Mailing Fax Number | 9047026004 |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2015-09-24 |
| Authorized Official Name | MR. MARC OWEN RAITT (PHARMACIST) |
| Authorized Official Telephone | 9047026171 |
| Authorized Official Credential | R.PH. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QC1800X |
Clinic/Center Specialization: Corporate Health |
PH 8064 | FL | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 109647800 | 05 |
| Street Address |
3627 UNIVERSITY BLVD S |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32216-4230 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124024310 | Eugene Rawson Griffin IIi | Family Medicine | 3627 University Blvd S, Ste 615, Jacksonville, FL 32216-7401 | 2005-06-22 |
| 1770020232 | Holly Noelle Anderson | Physician Assistant | 3627 University Blvd S, Suite 615, Jacksonville, FL 32216-4230 | 2017-01-23 |
| 1629510599 | Jennifer Sally Waldon | Physician Assistant | 3627 University Blvd S, Suite 615, Jacksonville, FL 32216-4230 | 2016-11-09 |
| 1922550474 | Digestive Disease Consultants | Internal Medicine | 3627 University Blvd S, Ste 430, Jacksonville, FL 32216-4230 | 2016-11-01 |
| 1235688359 | Megan Messer | Physician Assistant | 3627 University Blvd S, Suite 430, Jacksonville, FL 32216-4230 | 2016-09-30 |
| 1649632951 | Memorial Family Practice, LLC | Psychiatric Hospital | 3627 University Blvd S, Suite 235, Jacksonville, FL 32216-4230 | 2016-03-25 |
| 1215309539 | Payal Gohari | Pharmacist | 3627 University Blvd S, Suite 120, Jacksonville, FL 32216-4230 | 2015-10-26 |
| 1588033419 | Hayley Gant Patridge | Physician Assistant | 3627 University Blvd S, Suite 500, Jacksonville, FL 32216-4230 | 2015-09-22 |
| 1821495540 | Hillary Patton | Nurse Practitioner | 3627 University Blvd S, Jacksonville, FL 32216-4230 | 2014-11-24 |
| 1083059315 | Amy Lee Deichert | Speech-Language Pathologist | 3627 University Blvd S, Suite 210, Jacksonville, FL 32216-4230 | 2013-04-30 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013524925 | Renee Cherie Titus | Behavior Technician | Growing Together Center 6789 Southpoint Parkway, Building 100, Jacksonville, FL 32216 | 2020-09-24 |
| 1811546575 | First Coast Orthopedic Center, LLC | Clinic/Center | 4035 Southpoint Boulevard, Jacksonville, FL 32216 | 2019-09-05 |
| 1922578558 | Fatima Hussain Crofton | Optometrist | 7051 Southpoint Parkway S 300, Jacksonville, FL 32216 | 2018-11-27 |
| 1154802833 | John-paul Pham | Internal Medicine | 4141 Southpoint Drive East, Suite D, Jacksonville, FL 32216 | 2018-08-22 |
| 1790279479 | Joseph Richard Kennedy | Physician Assistant | 6650 Corporate Center Pkwy Apt 1604, Jacksonville, FL 32216 | 2018-06-18 |
| 1801304357 | Kelli M. Tyson | Nurse Practitioner | 3550 University Blvd. S., Ste 302, Jacksonville, FL 32216 | 2018-01-18 |
| 1376054809 | Angela M Whittinghill | Counselor | 8833 Perimeter Park Blvd #702, Jacksonville, FL 32216 | 2017-10-24 |
| 1629508072 | Zoryana Yufan | Dentist | 8750 Perimeter Park Blvd Ste 101, Jacksonville, FL 32216 | 2017-06-19 |
| 1700318896 | Christina Kaczmarek | Behavior Technician | 6816 Southpoint Pkwy Ste 500, Jacksonville, FL 32216 | 2017-03-29 |
| 1932640422 | Loudine Racius | Nurse Practitioner | 8539 Gate Parkway W, Unit 1422, Jacksonville, FL 32216 | 2017-03-16 |
| Find all providers in zip 32216 | ||||
| Taxonomy Code | 261QC1800X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Corporate Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841675881 | Variety Children's Hospital | Clinic/Center | 9487 Regency Square Blvd, Jacksonville, FL 32225-8183 | 2015-07-20 |
| 1881838084 | U.S. Preventive Medicine, Inc. | Clinic/Center | 12740 Gran Bay Pkwy W, Suite 2400, Jacksonville, FL 32258-5487 | 2009-05-01 |
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| 1699398891 | Covitest | Clinic/Center | 3450 W 84th St Ste 103a, Miami Lakes, FL 33018-4924 | 2020-05-21 |
| 1962987974 | National Healthcare Management Group | Clinic/Center | 920 Sw 154th Path, Miami, FL 33194-2744 | 2018-09-26 |
| 1700399664 | Hanover Medical Services of Dade, Inc | Clinic/Center | 8180 Doral Blvd Ste 416, Doral, FL 33166-6686 | 2017-11-14 |
| 1033594049 | Variety Children's Hospital | Clinic/Center | 1 Seminole Way, Hollywood, FL 33314-6407 | 2015-07-21 |
| 1083099022 | Variety Children's Hospital | Clinic/Center | 5223 Orient Rd, Tampa, FL 33610-4114 | 2015-07-20 |
| 1457736407 | Variety Children's Hospital | Clinic/Center | 3370 Forest Hill Blvd, West Palm Beach, FL 33406-5870 | 2015-07-20 |
| 1619318649 | Ergo Smarts, LLC | Clinic/Center | 9433 Trumpet Vine Loop, Trinity, FL 34655-5366 | 2013-07-06 |
| 1134370562 | Mark S Luedke Od Pa | Clinic/Center | 9433 Balm Riverview Rd, Ste 102, Riverview, FL 33569-5120 | 2008-10-03 |
| 1922058106 | On Site Medical Services, Inc | Clinic/Center | 1504 E Michigan St, Orlando, FL 32806-4819 | 2006-05-11 |
| 1750909362 | Mrs Health, Inc. | Clinic/Center | 8201 Peters Rd Ste 1000, Plantation, FL 33324-3266 | 2020-07-09 |
| Find all providers with the same taxonomy | ||||
| City | JACKSONVILLE |
| Zip Code | 32216 |
Please comment or provide details below to improve the information on THE APOTHECARY AT MEMORIAL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.