Macclenny Pharmacy Company

Primary specialty

PharmacyTaxonomy code 333600000X

Legal business name

MACCLENNY PHARMACY COMPANY

Practice address

1254 S 6TH St
D-1
Macclenny, FL 32063-4619

Phone

(904) 259-1116

Fax

(904) 259-1118

NPI assigned

Oct 13, 2010

Last updated

Oct 14, 2010By 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

Innocent Egbulam Opara, RPH

Title

Pharmacy Manager

Phone

(904) 259-1116

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1286928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287014400000",
    "number": "1346550209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5486 HIDDEN RIDGE DR",
            "address_2": "D-1",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322573217",
            "telephone_number": "904-259-1116",
            "fax_number": "904-259-1118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1254 S 6TH ST",
            "address_2": "D-1",
            "city": "MACCLENNY",
            "state": "FL",
            "postal_code": "320634619",
            "telephone_number": "904-259-1116",
            "fax_number": "904-259-1118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MACCLENNY PHARMACY COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-13",
        "last_updated": "2010-10-14",
        "status": "A",
        "authorized_official_last_name": "OPARA",
        "authorized_official_first_name": "INNOCENT",
        "authorized_official_middle_name": "EGBULAM",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "904-259-1116",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gregorio Trinidad Lim, M.D.
• Joseph Julian Lopez, MD
• Brandon T Loray
• Melissa Ludington, PHARM D.
• Taylor Lyles
• Claudette M Mallory, APRN
• Margaret L. Romeo, D.M.D.,P.a.
• Mary M Futch OD PA (Baker Vision Care)
• Shakeira S Maxwell
• Brookes McClellan, ARNP

• Pharmacy in Macclenny, FL
• Providers in Macclenny, FL by specialty
• Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2010; 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.