Organization Active NPI

Weise Prescription Shop Inc

  • Pharmacy
  • Jacksonville, FL
National Provider Identifier
1710052063
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
PH520 Issued in FL
Legal business name
WEISE PRESCRIPTION SHOP INC
Practice address
4343 Colonial Avenue
Jacksonville, FL 32210-3393
Phone
(904) 388-1564
Fax
(904) 384-0569
NPI assigned
Nov 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Gilbert Nelson Weise Jr., RPHNPI 1609217017
Title
Pharmacist Manager
Phone
(904) 388-1564

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X PH520 FL Primary

Addresses

Primary practice location

4343 Colonial Avenue
Jacksonville, FL 32210-3393

Mailing address

4343 Colonial Avenue
Jacksonville, FL 32210-3393
Phone (904) 388-1564

Other identifiers 1

IdentifierTypeStateIssuer
1012234OtherNABP

National Provider Directory

National Provider Directory

Locations

4343 Colonial Ave
Jacksonville, FL 32210
Phone (904) 388-1564

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1710052063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4343 COLONIAL AVENUE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322103393",
            "telephone_number": "904-388-1564",
            "fax_number": "904-384-0569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4343 COLONIAL AVENUE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322103393",
            "telephone_number": "904-388-1564",
            "fax_number": "904-384-0569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEISE PRESCRIPTION SHOP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WEISE",
        "authorized_official_first_name": "GILBERT",
        "authorized_official_middle_name": "NELSON",
        "authorized_official_title_or_position": "PHARMACIST  MANAGER",
        "authorized_official_telephone_number": "904-388-1564",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "FL",
            "license": "PH520",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "1012234",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.