MARIETTA PHARMACY LLC (NPI# 1912253774) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912253774 |
| Entity Type | Organization |
| Organization Name | MARIETTA PHARMACY LLC |
| Other Organization Name | MARIETTA PHARMACY |
| Practice Address |
8299 W Beaver St Ste 5 Jacksonville FL 32220-2315 |
| Practice Telephone | 9049994884 |
| Practice Fax Number | 9049994883 |
| Mailing Telephone | 9049994884 |
| Mailing Fax Number | 9049994883 |
| Enumeration Date | 2012-07-31 |
| Last Update Date | 2013-05-23 |
| Authorized Official Name | HANESH PATEL (RXM) |
| Authorized Official Telephone | 9049994884 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
PH26285 | FL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 007212200 | 05 | |
| NCPDP PROVIDER IDENTIFICATION NUMBER | 5711189 | 01 |
| Other Name | Type Code |
|---|---|
| MARIETTA PHARMACY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356724157 | Marietta Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 300 S Highway 77, Marietta, OK 73448-3447 | 2015-06-30 |
| Street Address |
8299 W BEAVER ST STE 5 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32220-2315 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083112064 | Azeb Muluneh | Pharmacist | 8299 W Beaver St Ste 5, Jacksonville, FL 32220-2315 | 2018-01-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679972665 | Marietta Dental Group | Dentist | 8209 W. Beaver St., Suite 100, Jacksonville, FL 32220 | 2014-08-15 |
| 1689631962 | Nicholas A Narducci | Dentist | 8209 W. Beaver Street, Suite 100, Jacksonville, FL 32220 | 2006-04-28 |
| 1649267857 | Kci Usa, Inc. | Durable Medical Equipment & Medical Supplies | 7029 Commonwealth Ave., Suite 2, Jacksonville, FL 32220 | 2005-10-03 |
| 1710356332 | Heavenly Angels Homemaker & Companion Services | In Home Supportive Care | 9695 Watershed Dr S, Jacksonville, FL 32220-0903 | 2015-09-24 |
| 1487138798 | Tiffany Mosley | Counselor | 9616 Watershed Dr E, Jacksonville, FL 32220-0905 | 2018-09-21 |
| 1861976003 | Earthly Stars, LLC | Home Health | 9616 Watershed Dr E, Jacksonville, FL 32220-0905 | 2018-09-24 |
| 1659848539 | Shanthalitta Seals Wallace | Counselor | 9617 Watershed Dr E, Jacksonville, FL 32220-0906 | 2018-10-29 |
| 1447306246 | Cynthia Jean Paulk | Speech-Language Pathologist | 9826 Watershed Dr W, Jacksonville, FL 32220-0911 | 2007-01-25 |
| 1497809644 | Tzipora S Johnson | Registered Nurse | 10278 Wellhouse Ct, Jacksonville, FL 32220-1351 | 2007-01-23 |
| 1528489002 | Connie Clark | Counselor | 620 Wellhouse Dr, Jacksonville, FL 32220-1367 | 2013-12-30 |
| Find all providers in zip 32220 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
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|---|---|---|---|---|
| 1285281071 | Sharshon Pharmacy Inc | Pharmacy | 154 W Morton Ave, Jacksonville, IL 62650 | 2019-08-26 |
| 1275191983 | University Pharmacy of Jacksonville, Inc | Pharmacy | 3901 University Blvd S Ste 237, Jacksonville, FL 32216-4390 | 2019-05-29 |
| 1992273023 | Public Square Pharmacy LLC | Pharmacy | 11757 Beach Blvd Ste 7, Jacksonville, FL 32246-6633 | 2018-11-07 |
| 1841707940 | Excel Pharmacy Partners LLC | Pharmacy | 6817 Southpoint Pkwy Ste 2204, Jacksonville, FL 32216-8200 | 2018-01-10 |
| 1144735556 | Costco Wholesale Corporation | Pharmacy | 8000 Parramore Rd, Jacksonville, FL 32244 | 2017-12-07 |
| 1912418286 | Av 1 Pharma LLC | Pharmacy | 1539 University Blvd N, Jacksonville, FL 32211-5229 | 2017-10-13 |
| 1629589908 | A V 2 Pharma LLC | Pharmacy | 1537 University Blvd N # Dn, Jacksonville, FL 32211-5229 | 2017-10-13 |
| 1881117109 | Summit Vision Inc. | Pharmacy | 3416 Moncrief Rd Ste 101, Jacksonville, FL 32209-4340 | 2017-07-18 |
| 1316486525 | Smart Pharmacy Inc | Pharmacy | 14003 Beach Blvd # 1, Jacksonville, FL 32250-1541 | 2017-02-21 |
| 1033565585 | New Lynk, LLC | Pharmacy | 5800 Beach Blvd Ste 105, Jacksonville, FL 32207-5180 | 2016-05-13 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32220 |
Please comment or provide details below to improve the information on MARIETTA PHARMACY LLC.
| 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.