Healthcare Provider Details

I. General information

NPI: 1699684357
Provider Name (Legal Business Name): MAYO PHARMACY AND WELLNESS CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

523 N MARION AVE
LAKE CITY FL
32055-2882
US

IV. Provider business mailing address

4846 NW LAKE JEFFERY RD
LAKE CITY FL
32055-4797
US

V. Phone/Fax

Practice location:
  • Phone: 386-344-1422
  • Fax:
Mailing address:
  • Phone: 386-344-1422
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DR. ERICA MAYO
Title or Position: OWNER/PRESIDENT
Credential: PHARMD
Phone: 386-344-1422