Individual provider Active NPI

Christos M Vasou, RPH

  • Pharmacist
  • Jacksonville, FL
National Provider Identifier
1871771956
Registry record updated Dec 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
041027 Issued in NY
Practice address
12387 Yellow Bluff Rd
Jacksonville, FL 32226-2025
Phone
(954) 751-2744
Fax
(904) 751-7524
NPI assigned
Jan 31, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS44635 FL
Pharmacist 183500000X 041027 NY Primary

Addresses

Primary practice location

12387 Yellow Bluff Rd
Jacksonville, FL 32226-2025

Mailing address

12387 Yellow Bluff Rd
Jacksonville, FL 32226-2025
Phone (904) 751-2744

Other practice location 1

3 White Pine Ct
Smithtown, NY 11787-1199
Phone (631) 724-0036

Other practice location 2

11166 Town View Dr
Jacksonville, FL 32256-4025
Phone (631) 433-1548

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
PS44635FLMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co CurrentSince Dec 28, 2022 Accepting new patients

Locations

12387 Yellow Bluff Rd
Jacksonville, FL 32226
Phone (904) 751-2744

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1201737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671408000000",
    "number": "1871771956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12387 YELLOW BLUFF RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322262025",
            "telephone_number": "904-751-2744",
            "fax_number": "904-751-7524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12387 YELLOW BLUFF RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322262025",
            "telephone_number": "954-751-2744",
            "fax_number": "904-751-7524"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3 White Pine Ct",
            "address_purpose": "LOCATION",
            "city": "Smithtown",
            "state": "NY",
            "postal_code": "117871199",
            "country_code": "US",
            "telephone_number": "631-724-0036",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11166 Town View Dr",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322564025",
            "country_code": "US",
            "telephone_number": "631-433-1548",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VASOU",
        "first_name": "CHRISTOS",
        "middle_name": "M",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-31",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS44635",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "041027",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Dec 19, 2022; 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.