Jag Pharmacy and Health Services

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PH26266 Issued in FL

Legal business name

JAG PHARMACY AND HEALTH SERVICES

Doing business as

45TH STREET PHARMACY

Practice address

5335 N Military TRL Ste 44
West Palm Beach, FL 33407-3033

Phone

(561) 670-2001

Fax

(561) 828-8454

NPI assigned

Jul 24, 2012

Organization subpart

No

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

Authorized official

Name

Ganiat Oluwamayowa

Title

Owner

Phone

(786) 877-9297

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• 45TH STREET PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1343088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461110400000",
    "number": "1073868386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5335 N MILITARY TRL STE 44",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334073033",
            "telephone_number": "561-670-2001",
            "fax_number": "561-828-8454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5335 N MILITARY TRL STE 44",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334073033",
            "telephone_number": "561-670-2001",
            "fax_number": "561-828-8454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAG PHARMACY AND HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-24",
        "last_updated": "2016-04-20",
        "status": "A",
        "authorized_official_last_name": "OLUWAMAYOWA",
        "authorized_official_first_name": "GANIAT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "786-877-9297"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH26266",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2136375",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007284500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "45TH STREET PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in West Palm Beach, FL
• Providers in West Palm Beach, 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 Apr 20, 2016; 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.