MAYPORT REFILL PHARMACY (NPI# 1932512498) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932512498 |
| Entity Type | Organization |
| Organization Name | MAYPORT REFILL PHARMACY |
| Practice Address |
Naval Health Clinic Mayport 2104 Massey Ave Mayport FL 32228 |
| Mailing Address |
Naval Hospital Jacksonville 2080 Child St Tpc-0601 Jacksonville FL 30214-5005 |
| Practice Telephone | 9042704205 |
| Practice Fax Number | 9042704544 |
| Mailing Telephone | 9042704205 |
| Mailing Fax Number | 9042704544 |
| Enumeration Date | 2014-06-03 |
| Last Update Date | 2017-10-15 |
| Authorized Official Name | WILLIAM M CONDON (BUMED UBO) |
| Authorized Official Telephone | 2404013643 |
| Is Organization Subpart | Y |
| Parent Organization Name | NAVAL HOSPITAL JACKSONVILLE |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332000000X | Military/U.S. Coast Guard Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2146066 | 01 |
| Street Address |
NAVAL HEALTH CLINIC MAYPORT 2104 MASSEY AVE |
| City | MAYPORT |
| State | FL |
| Zip Code | 32228 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023546108 | Gregory Donald Willden | Military Health Care Provider | Bon Homme Richard St, Bldg 2480, Jacksonville, FL 32228 | 2017-06-01 |
| 1235681545 | Huriel A Rivera Aponte | Military Health Care Provider | Naval Station Mayport, Surflant Medical Readiness Division Detachment Mayport, Jacksonville, FL 32228 | 2016-11-03 |
| 1871950667 | Julie Nicole Boisen | General Practice | Bldg 1320, Waterfront Medical, Mayport, FL 32228 | 2016-01-25 |
| 1134594245 | Luis Figueroa | Military Health Care Provider | Lcsron Two, 2480 Bonhomme Richard St, Jacksonville, FL 32228 | 2015-12-01 |
| 1790154813 | Franklin Paul Mccullough | Military Health Care Provider | Bon Homme St Bldg 2480, Jacksonville, FL 32228 | 2015-09-18 |
| 1366863102 | Clayton Pascik | Military Health Care Provider | Bldg 1488 Massey Ave., Jacksonville, FL 32228 | 2013-12-20 |
| 1104267533 | Joshua Israel Keil | Optometrist | Building 2104 Massey Avenue, Nas Mayport, FL 32228 | 2013-07-15 |
| 1588907042 | Devon Schefano | Military Health Care Provider | 1204 Massey Ave, Mayport, FL 32228 | 2013-04-03 |
| 1851686554 | Philip M Yam | Psychiatry & Neurology | Cnss-14, Mrd Bld 1320, Mayport Naval Station, Jacksonville, FL 32228 | 2011-06-10 |
| 1518297829 | Mary Louise Allen | Nurse Practitioner | Massey Ave Bldg 2104, Mayport, FL 32228 | 2010-01-08 |
| Find all providers in zip 32228 | ||||
| Taxonomy Code | 332000000X |
| Grouping | Suppliers |
| Classification | Military/U.S. Coast Guard Pharmacy |
| A Department of Defense (DoD) or U.S. Coast Guard entity whose primary function is to store, prepare and dispense pharmaceuticals and other associated items to Uniformed Services beneficiaries. These pharmacies may be associated with a DoD or U.S. Coast Guard clinic, DoD Hospital or freestanding. Usually associated with outpatient services. |
| Notes: Source: TRICARE Management Activity Uniform Business Office User’s Guide [1/1/2005: new; 7/1/2006: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831298595 | Mayport Pharmacy | Military/U.S. Coast Guard Pharmacy | Bldg 1363, Naval Air Station, Mayport, FL 32228-0148 | 2006-09-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114425113 | Naval Hospital Pensacola | Military/U.S. Coast Guard Pharmacy | 2500 Veterans Way, Bldg 645, Panama City, FL 32408 | 2018-01-25 |
| 1134518798 | 96th Medical Support Squadron | Military/U.S. Coast Guard Pharmacy | 3120 A. Talon Way, Eglin Afb Fld #3, FL 32542 | 2015-01-20 |
| 1457764078 | Naval Hospital Pensacola | Military/U.S. Coast Guard Pharmacy | 5820 W Highway 98, Pensacola, FL 32507-1072 | 2014-06-11 |
| 1437562626 | Naval Hospital Pensacola | Military/U.S. Coast Guard Pharmacy | 7119 Langley St Bldg 2985, Milton, FL 32570-6105 | 2014-06-05 |
| 1770995300 | Jacksonville Refill Pharmacy | Military/U.S. Coast Guard Pharmacy | Navy Exchange Pharmacy, Bldg 950, Jacksonville, FL 32214-5000 | 2014-06-02 |
| 1598177123 | 96th Medical Support Squadron | Military/U.S. Coast Guard Pharmacy | 96 Medical Group Satellite Phcy Memorial Trail, Bldg. 1758, Eglin Afb, FL 32542 | 2014-06-02 |
| 1518301696 | Naval Hospital Pensacola | Military/U.S. Coast Guard Pharmacy | 5820 West Highway 98, Bldg 3737, Pensacola, FL 32507 | 2013-04-19 |
| 1356653844 | Us Coast Guard Finance Center | Military/U.S. Coast Guard Pharmacy | 100 Trumbo Point Road, Key West, FL 33040 | 2010-07-13 |
| 1518051093 | Hrs Citrus County Health Dept. Pharmacy | Military/U.S. Coast Guard Pharmacy | 2804 Marc Knighton Ct, Lecanto, FL 34461 | 2006-10-02 |
| 1285733907 | 325th Medical Group Sgsl | Military/U.S. Coast Guard Pharmacy | Magnolia Circle, Tyndall Afb, FL 32403 | 2006-09-21 |
| Find all providers with the same taxonomy | ||||
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| 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.