Jai Guru Maharaj Inc

Primary specialty

Compounding PharmacyTaxonomy code 3336C0004X

License

PH22533 Issued in FL

Legal business name

JAI GURU MAHARAJ INC

Doing business as

Freedom Pharmacy

Practice address

10700 Johnson Blvd
Ste 1
Seminole, FL 33772-4821

Phone

(727) 397-5020

Fax

(727) 397-9381

NPI assigned

Aug 6, 2007

Last updated

Sep 13, 2007By 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

Philip Burdsal

Title

President

Phone

(813) 368-3277

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• FREEDOM PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1186358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189641600000",
    "number": "1689865487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10700 JOHNSON BLVD",
            "address_2": "STE 1",
            "city": "SEMINOLE",
            "state": "FL",
            "postal_code": "337724821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10700 JOHNSON BLVD",
            "address_2": "STE 1",
            "city": "SEMINOLE",
            "state": "FL",
            "postal_code": "337724821",
            "telephone_number": "727-397-5020",
            "fax_number": "727-397-9381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAI GURU MAHARAJ INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-06",
        "last_updated": "2007-09-13",
        "status": "A",
        "authorized_official_last_name": "BURDSAL",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-368-3277"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "FL",
            "license": "PH22533",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "1027956",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FREEDOM PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Colette Iwanski
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• Alec Jackson
• Carie Jackson, D.C.
• Jeanette Marie Jacques, MA, CCC-SLP
• James R Johnson DO PA
• Jane M. Nichilo, Arnp, LLC
• Brian Lewis Jaques, DMD
• Robert J Jenkins
• Jenna Godwin LLC

• Compounding Pharmacy in Seminole, FL
• Providers in Seminole, FL by specialty
• Compounding Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 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.