NPIMap

Organization Active NPI

Jackson Pharmacy LLC

  • Community/Retail Pharmacy
  • Miami, FL
National Provider Identifier
1023048071
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
JACKSON PHARMACY LLC
Practice address
940 SW 87 Ave
Miami, FL 33144
Phone
(305) 403-0210
Fax
(305) 722-0678
NPI assigned
Jul 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Gavroche Fernandez
Title
President
Phone
(305) 403-0210

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

940 SW 87 Ave
Miami, FL 33144

Mailing address

940 SW 87 Ave
Miami, FL 33144
Phone (305) 403-0210

National Provider Directory

National Provider Directory
Tax ID family
Jackson Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1023048071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 SW 87 AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33144",
            "telephone_number": "305-403-0210",
            "fax_number": "305-722-0678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 SW 87 AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33144",
            "telephone_number": "305-403-0210",
            "fax_number": "305-722-0678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FERNANDEZ",
        "authorized_official_first_name": "GAVROCHE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-403-0210"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.