Waas Drug Store Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PH1804 Issued in FL

Legal business name

WAAS DRUG STORE INC

Practice address

1551 S 14TH St
Ste 1
Fernandina Beach, FL 32034-1930

Phone

(904) 261-3171

Fax

(904) 321-0685

NPI assigned

Dec 4, 2006

Organization subpart

No

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

Authorized official

Name

James Parker, RPH

Title

Pres

Phone

(904) 261-3171

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• WAAS DRUG STORE Doing business as

Locations

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475107200000",
    "number": "1104994342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 518",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320350518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 S 14TH ST",
            "address_2": "STE 1",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320341930",
            "telephone_number": "904-261-3171",
            "fax_number": "904-321-0685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAAS DRUG STORE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2016-09-29",
        "status": "A",
        "authorized_official_last_name": "PARKER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "904-261-3171",
        "authorized_official_credential": "RPH"
    },
    "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": "PH1804",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102064100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2004149",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WAAS DRUG STORE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Fernandina Beach, FL
• Providers in Fernandina 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 Sep 29, 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.