Healthcare Provider Details

I. General information

NPI: 1710804604
Provider Name (Legal Business Name): NEXTGEN PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7685 103RD ST STE 202
JACKSONVILLE FL
32210-9325
US

IV. Provider business mailing address

7685 103RD ST STE 202
JACKSONVILLE FL
32210-9325
US

V. Phone/Fax

Practice location:
  • Phone: 314-629-5794
  • Fax:
Mailing address:
  • Phone: 314-629-5794
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: FAROOQ AMIN BAJWA
Title or Position: OWNER
Credential:
Phone: 330-382-4238