NPIMap

Organization Active NPI

Neptune Beach Pharmacy LLC

Doing business as Neptune Beach Pharmacy

  • Community/Retail Pharmacy
  • Neptune Beach, FL
National Provider Identifier
1518212182
Registry record updated Nov 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PH26227 Issued in FL
Legal business name
NEPTUNE BEACH PHARMACY LLC
Doing business as
Neptune Beach Pharmacy
Practice address
1529 Atlantic Blvd
Neptune Beach, FL 32266-1717
Phone
(904) 685-4919
Fax
(904) 685-2390
NPI assigned
Jul 19, 2012
Last updated
Nov 14, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2012

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

Authorized official

Name
Edet Sampson
Title
Pharmacist Owner
Phone
(904) 619-3450

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PH26227 FL Primary

Addresses

Primary practice location

1529 Atlantic Blvd
Neptune Beach, FL 32266-1717

Mailing address

1529 Atlantic Blvd
Neptune Beach, FL 32266-1717
Phone (904) 685-4919

Other identifiers 1

IdentifierTypeStateIssuer
5710911OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • Neptune Beach Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Neptune Beach Pharmacy2 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

1529 Atlantic Blvd
Neptune Beach, FL 32266
Phone (904) 685-4919

NPI Registry JSON

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

{
    "created_epoch": "1342656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352851200000",
    "number": "1518212182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1529 ATLANTIC BLVD",
            "city": "NEPTUNE BEACH",
            "state": "FL",
            "postal_code": "322661717",
            "telephone_number": "904-685-4919",
            "fax_number": "904-685-2390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1529 ATLANTIC BLVD",
            "city": "NEPTUNE BEACH",
            "state": "FL",
            "postal_code": "322661717",
            "telephone_number": "904-685-4919",
            "fax_number": "904-685-2390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEPTUNE BEACH PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-19",
        "last_updated": "2012-11-14",
        "status": "A",
        "authorized_official_last_name": "SAMPSON",
        "authorized_official_first_name": "EDET",
        "authorized_official_title_or_position": "PHARMACIST OWNER",
        "authorized_official_telephone_number": "904-619-3450"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH26227",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "5710911",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Neptune Beach Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Neptune Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2012; 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.