Healthcare Provider Details

I. General information

NPI: 1548648363
Provider Name (Legal Business Name): CAREMAX PHARMACY 725 LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2015
Last Update Date: 07/19/2023
Certification Date: 07/19/2023
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: 904-551-9026
  • Fax: 866-725-5332
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPH27672
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

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