Organization Active NPI

Seton Pharmacy Inc

  • Community/Retail Pharmacy
  • Jacksonville, FL
National Provider Identifier
1235559469
Registry record updated Jul 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PH28043 Issued in FL
Legal business name
SETON PHARMACY INC
Doing business as
Seton Pharmacy Northside
Practice address
1760 Edgewood Ave W Ste C
Jacksonville, FL 32208-7209
Phone
(904) 450-8787
Fax
(904) 924-1145
NPI assigned
Apr 28, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2015

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

Authorized official

Name
Charzetta James
Title
Pharmacy Director,Ao
Phone
(904) 450-8787

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PH28043 FL Primary

Addresses

Primary practice location

1760 Edgewood Ave W Ste C
Jacksonville, FL 32208-7209

Mailing address

1760 Edgewood Ave W
Suite C
Jacksonville, FL 32208-7209
Phone (904) 450-8787

Other identifiers 2

IdentifierTypeStateIssuer
013794500MedicaidFL
2148118OtherPK

Other names 1

  • Seton Pharmacy Northside Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Seton Pharmacy Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1760 Edgewood Ave W
Ste C
Jacksonville, FL 32208
Phone (904) 450-8787

Practitioners & affiliated clinicians

Practitioners 1

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": "1398643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436227200000",
    "number": "1235559469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1760 EDGEWOOD AVE W",
            "address_2": "SUITE C",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322087209",
            "telephone_number": "904-450-8787",
            "fax_number": "904-924-1145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1760 EDGEWOOD AVE W STE C",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322087209",
            "telephone_number": "904-450-8787",
            "fax_number": "904-924-1145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SETON PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-28",
        "last_updated": "2015-07-07",
        "status": "A",
        "authorized_official_last_name": "JAMES",
        "authorized_official_first_name": "CHARZETTA",
        "authorized_official_title_or_position": "PHARMACY DIRECTOR,AO",
        "authorized_official_telephone_number": "904-450-8787"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH28043",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "013794500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2148118",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Seton Pharmacy Northside",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 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.