Willie Edward Long

Primary specialty

PharmacistTaxonomy code 183500000X

License

PS0018438 Issued in FL

Practice address

201 W 48TH St
Jacksonville, FL 32208-5230

Phone

(904) 766-4700

Fax

(904) 764-4900

NPI assigned

Feb 19, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1679617898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 551444",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322551444",
            "telephone_number": "904-766-4700",
            "fax_number": "904-764-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 W 48TH ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322085230",
            "telephone_number": "904-766-4700",
            "fax_number": "904-764-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "WILLIE",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-19",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS0018438",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPD NUMBER",
            "identifier": "1077848",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ralph Long Jr., PHARMD
• Ryan R Long, DDS
• Steven Dwight Long III, PT
• Tafana A Long
• William Hanover Long, M.D.
• Ashley Longabaugh-Cantos, LMHC
• Diana Dudenkova Longacre, APRN
• Vanessa V Longacre, APRN
• James Andrew Longenbach, M.D.
• Stanton L Longenecker, MD

• Pharmacist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Pharmacist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.