Omjrb LLC

Primary specialty

PharmacyTaxonomy code 333600000X

License

PH28791 Issued in FL

Legal business name

OMJRB LLC

Practice address

2722 W Old US Highway 441
Mount Dora, FL 32757-3503

Phone

(407) 738-0972

Fax

(877) 599-6183

NPI assigned

Jan 13, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Vimal Patel, R.PH

Title

Owner

Phone

(407) 738-0972

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• MEDICINE STORE Doing business as

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

{
    "created_epoch": "1421107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421107200000",
    "number": "1124417241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2722 W OLD US HIGHWAY 441",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327573503",
            "telephone_number": "407-738-0972",
            "fax_number": "877-599-6183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2722 W OLD US HIGHWAY 441",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327573503",
            "telephone_number": "407-738-0972",
            "fax_number": "877-599-6183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMJRB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-13",
        "last_updated": "2015-01-13",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "VIMAL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-738-0972",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.PH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "FL",
            "license": "PH28791",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY LICENSE NUMBER FOR STATE OF FLORIDA",
            "identifier": "PH28791",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEDICINE STORE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pharmacy in Mount Dora, FL
• Providers in Mount Dora, FL by specialty
• Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 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.