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NPI Code Detail

MEDICARE: MR. MANDEL JERMAINE HEARNS PHARM. D

MEDICARE: MR. MANDEL JERMAINE HEARNS PHARM. D
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistPS33463FL

General Provider Information

NPI Number : 1851672190
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MANDEL JERMAINE HEARNS PHARM. D
Provider Business Mailing Address
First Line : 9455 WOODLEIGH MILL DR
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32244-7918
Country : US
Telephone Number : 904-778-1750
Fax Number :
Provider Business Practice Location Address
First Line : 9700 ARGYLE FOREST BLVD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32222-2809
Country : US
Telephone Number : 904-778-0871
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2011
Last Update Date : 08/31/2011

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