Organization Active NPI

Jay Care Pharmacy LLC

  • Community/Retail Pharmacy
  • Panama City, FL
National Provider Identifier
1083129175
Registry record updated Jul 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
31079 Issued in FL
Legal business name
JAY CARE PHARMACY LLC
Practice address
1212 W 23Rd St
Panama City, FL 32405-3609
Phone
(850) 640-4810
Fax
(850) 640-4329
NPI assigned
Dec 11, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2018

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

Authorized official

Name
Susheel JangaNPI 1952880890
Title
Owner/President/Ao
Phone
(405) 503-9927

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 31079 FL Primary

Addresses

Primary practice location

1212 W 23Rd St
Panama City, FL 32405-3609

Mailing address

1212 W 23Rd St
Panama City, FL 32405-3609
Phone (850) 640-4810

Other identifiers 1

IdentifierTypeStateIssuer
2175151OtherPK

Other names 1

  • Jay Care Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210203003013 FL Part B Supplier - Pharmacy 1355755281 Practice locations: Panama City, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2225853Jay Care Pharmacy LLC1212 W 23Rd St, Panama City, FL 32405Certificate of waiverMay 24, 2027

National Provider Directory

National Provider Directory

Locations

1212 W 23rd St
Panama City, FL 32405
Phone (850) 640-4810

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1512950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531958400000",
    "number": "1083129175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1212 W 23RD ST",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324053609",
            "telephone_number": "850-640-4810",
            "fax_number": "850-640-4329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 W 23RD ST",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324053609",
            "telephone_number": "850-640-4810",
            "fax_number": "850-640-4329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAY CARE PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-11",
        "last_updated": "2018-07-19",
        "status": "A",
        "authorized_official_last_name": "JANGA",
        "authorized_official_first_name": "SUSHEEL",
        "authorized_official_title_or_position": "OWNER/PRESIDENT/AO",
        "authorized_official_telephone_number": "405-503-9927"
    },
    "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": "31079",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2175151",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jay Care Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Jay Care Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Panama City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.