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General NPI Number Information
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NPI Number | 1093597544
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Entity Type | Organization
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Legal Business Name | PBJ MEDICAL RX LLC
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Dates
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Enumeration Date | 10/19/2023
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Last Update Date | 02/13/2025
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Provider Practice Location Address
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Address Line | 7380 W SAND LAKE RD
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City | ORLANDO
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State | FL
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Zip | 32819-5248
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Country | US
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Telephone | 800-485-7962
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Fax |
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Provider Business Mailing Address
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Address Line | 7380 W SAND LAKE RD STE 500
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City | ORLANDO
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State | FL
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Zip | 32819-5257
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Country | US
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Telephone | 800-485-7962
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Fax | 888-492-2004
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Authorized Official
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Title or Position | OPERATION MANAGER
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Name | DR. DWAYNE JONES SR.
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Credential | PHARMACIST
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Telephone | 800-485-7962
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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