NPIMap

Organization Active NPI

Med Ex

  • Preferred Provider Organization
  • Palatka, FL
National Provider Identifier
1346481629
Registry record updated Mar 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preferred Provider OrganizationTaxonomy code 305R00000X
License
ME54477 Issued in FL
Legal business name
MED EX
Practice address
6500 Crill Ave
Palatka, FL 32177-6807
Phone
(904) 739-1309
Fax
(904) 739-1310
NPI assigned
Mar 16, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2009

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

Authorized official

Name
Chris Brantley
Title
Pharmacy Administrator
Phone
(904) 739-1309

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Preferred Provider Organization 305R00000X ME54477 FL Primary

Addresses

Primary practice location

6500 Crill Ave
Palatka, FL 32177-6807

Mailing address

PO Box 10890
Jacksonville, FL 32247-0890
Phone (904) 739-1309

National Provider Directory

National Provider Directory
Tax ID family
Donald Geldart MD6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

NPI Registry JSON

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

{
    "created_epoch": "1237161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237161600000",
    "number": "1346481629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10890",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322470890",
            "telephone_number": "904-739-1309",
            "fax_number": "904-739-1310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 CRILL AVE",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "321776807",
            "telephone_number": "904-739-1309",
            "fax_number": "904-739-1310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MED EX",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-16",
        "last_updated": "2009-03-16",
        "status": "A",
        "authorized_official_last_name": "BRANTLEY",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "PHARMACY ADMINISTRATOR",
        "authorized_official_telephone_number": "904-739-1309"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "FL",
            "license": "ME54477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palatka, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2009; 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.