Healthcare Provider Details
I. General information
NPI: 1922713577
Provider Name (Legal Business Name): ANAY INVESTMENTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/18/2023
Last Update Date: 06/22/2023
Certification Date: 06/22/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
126 S COUNTY ROAD 315 STE A
INTERLACHEN FL
32148-5418
US
IV. Provider business mailing address
PO BOX 600873
SAINT JOHNS FL
32260-0873
US
V. Phone/Fax
- Phone: 386-400-3545
- Fax: 386-259-6061
- Phone: 386-400-3545
- Fax: 386-259-6061
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336L0003X |
| Taxonomy | Long Term Care Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
SAMIR
M
JARECHA
Title or Position: MANAGING MEMBER AO
Credential:
Phone: 386-400-3545