Banyanites - 2 LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PH31057 Issued in FL

Legal business name

BANYANITES - 2 LLC

Practice address

11048 Baymeadows Rd Unit 5
Jacksonville, FL 32256-9583

Phone

(904) 240-1101

Fax

(904) 204-1128

NPI assigned

Nov 30, 2017

Organization subpart

No

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

Authorized official

Name

Manan Patel

Title

Owner,President,Ao

Phone

(904) 814-5933

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• BENZER PHARMACY Other name

Locations

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

{
    "created_epoch": "1512000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525392000000",
    "number": "1174037063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11048 BAYMEADOWS RD UNIT 5",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322569583",
            "telephone_number": "904-240-1101",
            "fax_number": "904-204-1128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11048 BAYMEADOWS RD UNIT 5",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322569583",
            "telephone_number": "904-240-1101",
            "fax_number": "904-204-1128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BANYANITES - 2 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-30",
        "last_updated": "2018-05-04",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "MANAN",
        "authorized_official_title_or_position": "OWNER,PRESIDENT,AO",
        "authorized_official_telephone_number": "904-814-5933"
    },
    "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": "PH31057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2174467",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BENZER PHARMACY",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Community/Retail Pharmacy in Jacksonville, FL
• Providers in Jacksonville, 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 May 4, 2018; 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.