Spring Park Pharmacy LLC

Primary specialty

PharmacyTaxonomy code 333600000X

License

PH31080 Issued in FL

Legal business name

SPRING PARK PHARMACY LLC

Practice address

3851 Emerson St Ste 13
Jacksonville, FL 32207

Phone

(904) 551-5094

Fax

(904) 527-1244

NPI assigned

Dec 12, 2017

Organization subpart

No

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

Authorized official

Name

Stacy ChaoNPI 1942828512

Title

Pharmacist in Charge

Phone

(904) 551-5094

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• Spring Park Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in FL3 enrollments

Enrollment records 3

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

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

• Stacy Chao

  • Pharmacist
  • Jacksonville, FL
  • NPI 1942828512
  NPD Authorized official

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

{
    "created_epoch": "1513036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531699200000",
    "number": "1902311046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4446 HENDRICKS AVE STE 408",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322076369",
            "telephone_number": "904-551-5094",
            "fax_number": "904-527-1244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3851 EMERSON ST STE 13",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32207",
            "telephone_number": "904-551-5094",
            "fax_number": "904-527-1244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPRING PARK PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-12",
        "last_updated": "2018-07-16",
        "status": "A",
        "authorized_official_last_name": "CHAO",
        "authorized_official_first_name": "STACY",
        "authorized_official_title_or_position": "PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "904-551-5094"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BN1400X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "FL",
            "license": "PH31080",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2175032",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spring Park Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Spring Park Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jennifer Spradley, OTR/L
• Rebecca Spradley
• Meredith Sprague, PT, DPT
• Richard S Sprague Jr., MD
• Robert C Sprecher, MD
• Bryan Donald Springer, MD
• Robert C Springer, DO
• Lance Chau Springfield, PHARM.D.
• Samuel Sprinkle
• Toya Tmour Sproul, PBT

• Pharmacy in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.