Callahan Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PH24482 Issued in FL

Legal business name

CALLAHAN PHARMACY INC

Doing business as

callahan pharmacy

Practice address

450077 State Road 200
Callahan, FL 32011-3863

Phone

(904) 628-0365

Fax

(904) 628-0380

NPI assigned

Jan 28, 2010

Last updated

Feb 20, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Abdalla Adam

Title

President/Pharmacist in Charge

Phone

(904) 651-0055

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• callahan pharmacy Doing business as

Locations

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

{
    "created_epoch": "1264636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487548800000",
    "number": "1306177530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2704 SECRET HARBOR DR",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320657675",
            "telephone_number": "904-651-0055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450077 STATE ROAD 200",
            "city": "CALLAHAN",
            "state": "FL",
            "postal_code": "320113863",
            "telephone_number": "904-628-0365",
            "fax_number": "904-628-0380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALLAHAN PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-28",
        "last_updated": "2017-02-20",
        "status": "A",
        "authorized_official_last_name": "ADAM",
        "authorized_official_first_name": "ABDALLA",
        "authorized_official_title_or_position": "PRESIDENT/PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "904-651-0055"
    },
    "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": "PH24482",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002370200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2124046",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "callahan pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Melissa Thick Cannon, APRN FNP-C
• Phillips Cao
• Shannon Marie Cislo, PA-C
• John Leon Clark, DPM
• Madison Clayton

• Community/Retail Pharmacy in Callahan, FL
• Providers in Callahan, 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 Feb 20, 2017; 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.