Jet Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PH24178 Issued in FL

Legal business name

JET PHARMACY LLC

Practice address

2310 W Waters Ave
Ste J
Tampa, FL 33604-2764

Phone

(813) 933-3458

Fax

(813) 935-5163

NPI assigned

Aug 11, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Charles Smith

Title

RPH

Phone

(813) 933-3458

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• JET PHARMACY Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1249948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442275200000",
    "number": "1003048950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2310 W WATERS AVE",
            "address_2": "STE J",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336042764",
            "telephone_number": "813-933-3458",
            "fax_number": "813-935-5163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2310 W WATERS AVE",
            "address_2": "STE J",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336042764",
            "telephone_number": "813-933-3458",
            "fax_number": "813-935-5163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JET PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-11",
        "last_updated": "2015-09-15",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "RPH",
        "authorized_official_telephone_number": "813-933-3458"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH24178",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2121317",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001437200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JET PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Tampa, FL
• Providers in Tampa, FL by specialty
• Community/Retail Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.