The Medimix, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PH25863 Issued in FL

Legal business name

THE MEDIMIX, LLC

Doing business as

Medimix Specialty Pharmacy

Practice address

6820 Southpoint Pkwy
Suite 9
Jacksonville, FL 32216-6276

Phone

(904) 567-6334

Fax

(866) 745-6334

NPI assigned

Dec 22, 2011

Last updated

Dec 22, 2011By 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

Jeron Stokes

Title

MGR

Phone

(904) 567-6334

Specialties & licenses 2

Addresses

Other names 1

• Medimix Specialty Pharmacy Doing business as

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

{
    "created_epoch": "1324512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324512000000",
    "number": "1861761694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6820 SOUTHPOINT PKWY",
            "address_2": "SUITE 9",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322166276",
            "telephone_number": "904-567-6334",
            "fax_number": "866-745-6334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6820 SOUTHPOINT PKWY",
            "address_2": "SUITE 9",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322166276",
            "telephone_number": "904-567-6334",
            "fax_number": "866-745-6334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE MEDIMIX, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-22",
        "last_updated": "2011-12-22",
        "status": "A",
        "authorized_official_last_name": "STOKES",
        "authorized_official_first_name": "JERON",
        "authorized_official_title_or_position": "MGR",
        "authorized_official_telephone_number": "904-567-6334"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH25863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medimix Specialty Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Jacksonville, FL
• Providers in Jacksonville, 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 Dec 22, 2011; 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.