Whole Life Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PH27103 Issued in FL

Legal business name

WHOLE LIFE PHARMACY

Practice address

10575 Dixie Hwy
Ponte Vedra, FL 32081

Phone

(904) 827-0177

Fax

(855) 319-9872

NPI assigned

Sep 12, 2013

Organization subpart

No

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

Authorized official

Name

Mrs. Tiffany Amber Heath, PHARMD

Title

Pharmacy Manager

Phone

(904) 827-0177

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1378944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390435200000",
    "number": "1336574003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2465 US 1 S STE 62",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320866076",
            "telephone_number": "904-827-0177",
            "fax_number": "855-319-9872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10575 DIXIE HWY",
            "city": "PONTE VEDRA",
            "state": "FL",
            "postal_code": "32081",
            "telephone_number": "904-827-0177",
            "fax_number": "855-319-9872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHOLE LIFE PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-12",
        "last_updated": "2014-01-23",
        "status": "A",
        "authorized_official_last_name": "HEATH",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_middle_name": "AMBER",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "904-827-0177",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH27103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Retail Pharmacy in Ponte Vedra, FL
• Providers in Ponte Vedra, 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 Jan 23, 2014; 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.