Orange Park Pharmacy Inc.
Organization Active NPI Community/Retail Pharmacy · Orange Park, FL
NPI 1649513482 · NPPES record last updated Dec 9, 2024
Key facts
- NPI
- 1649513482
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- PH26578 (FL)
- Legal business name
- ORANGE PARK PHARMACY INC.
- Practice address
- 1992 Kingsley Ave
Orange Park, FL 32073-4442 - Phone
- (904) 579-3027
- Fax
- (904) 579-4551
- NPI assigned
- Mar 29, 2013
- Organization subpart
- No
Authorized official
- Name
- Cho Nkengka
- Title
- Owner
- Phone
- (904) 579-3027
Corporate family (same tax ID) 1
Practitioners 3
-
Adam Christopher Kelley, PHARMD
-
Abdalla Mohamed, PHARMD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130827000845 | FL | Part B Supplier - Pharmacy | 1850534504 | Practice locations: Orange Park, FL |
National Provider Directory
- Tax ID family
- Orange Park Pharmacy Inc
Locations
1992 Kingsley Ave
Orange Park, FL 32073
Phone (904) 579-3027
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Community/Retail Pharmacy | 3336C0003X | PH26578 | FL | Yes |
Addresses
Primary practice location
1992 Kingsley Ave
Orange Park, FL 32073-4442
Mailing address
1992 Kingsley Ave
Orange Park, FL 32073-4442
Phone (904) 579-3027
Other providers in Orange Park, FL
- Orange Park Nursing LLC
- Orange Park Opco LLC
- Orange Park Orthopaedic Associates, P.a.
- Orange Park Pediatric Associates, PA
- Orange Park Pharmacy Inc
- Orange Park Rehabilitation and Nursing Center LLC
- Orange Park Sleep Center LLC
- Orange Park Spine Institute LLC
- Kathryn Orason
- Colleen Orbegoso
All providers in Orange Park, FL · Community/Retail Pharmacy in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 9, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.