Fleming Island Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PH27325 Issued in FL

Legal business name

FLEMING ISLAND PHARMACY LLC

Doing business as

Fleming Island Pharmacy

Practice address

2349 Village Square Pkwy Ste 106
Fleming Island, FL 32003-4319

Phone

(904) 644-8233

Fax

(904) 458-4444

NPI assigned

Sep 3, 2014

Organization subpart

No

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

Authorized official

Name

Mikhil Joseph, PHARMD.

Title

Pharmacist/Owner

Phone

(904) 718-7352

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• Fleming Island Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1409702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487548800000",
    "number": "1760882245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2349 VILLAGE SQUARE PKWY STE 106",
            "address_2": "SUITE# 106",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "320034319",
            "telephone_number": "904-644-8233",
            "fax_number": "904-458-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2349 VILLAGE SQUARE PKWY STE 106",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "320034319",
            "telephone_number": "904-644-8233",
            "fax_number": "904-458-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLEMING ISLAND PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-03",
        "last_updated": "2017-02-20",
        "status": "A",
        "authorized_official_last_name": "JOSEPH",
        "authorized_official_first_name": "MIKHIL",
        "authorized_official_title_or_position": "PHARMACIST/OWNER",
        "authorized_official_telephone_number": "904-718-7352",
        "authorized_official_credential": "PHARMD."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH27325",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "013196400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2147634",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fleming Island Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Florida Department of Health

• Community/Retail Pharmacy in Fleming Island, FL
• Providers in Fleming Island, FL by specialty
• Community/Retail Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2017; 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.