Healthcare Provider Details

I. General information

NPI: 1841926094
Provider Name (Legal Business Name): BLUEBIRD SPECIALTY PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2022
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8110 CYPRESS PLAZA DR STE 301
JACKSONVILLE FL
32256-4468
US

IV. Provider business mailing address

9158 STARPASS DR
JACKSONVILLE FL
32256-5474
US

V. Phone/Fax

Practice location:
  • Phone: 704-804-3600
  • Fax:
Mailing address:
  • Phone: 904-900-7077
  • Fax: 904-900-7078

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ANNA MOYER
Title or Position: MANAGER
Credential: PHARM.D.
Phone: 704-804-3600