Healthcare Provider Details

I. General information

NPI: 1336741263
Provider Name (Legal Business Name): CAREMAX PHARMACY 725 LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2020
Last Update Date: 01/11/2022
Certification Date: 01/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5547 NORMANDY BLVD
JACKSONVILLE FL
32205-6246
US

IV. Provider business mailing address

PO BOX 600914
JACKSONVILLE FL
32260-0914
US

V. Phone/Fax

Practice location:
  • Phone: 904-374-2692
  • Fax: 866-725-5332
Mailing address:
  • Phone: 904-386-6785
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ANKURKUMAR ASHOKKUMAR PARIKH
Title or Position: AUTHORIZED USER
Credential:
Phone: 904-386-6785