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General NPI Number Information
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NPI Number | 1467597799
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Entity Type | Organization
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Legal Business Name | JAY PHARMACY OF JAY FLORIDA INC
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Dates
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Enumeration Date | 02/21/2007
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Last Update Date | 01/18/2017
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Provider Practice Location Address
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Address Line | 14088 ALABAMA ST
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City | JAY
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State | FL
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Zip | 32565-1036
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Country | US
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Telephone | 850-675-6666
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Fax | 850-675-4666
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Provider Business Mailing Address
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Address Line | PO BOX 367
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City | JAY
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State | FL
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Zip | 32565-0367
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Country | US
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Telephone | 850-675-6666
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Fax | 850-675-4006
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Authorized Official
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Title or Position | PHARMACY MANAGER
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Name | JOEY HART
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Credential | PHARMACY
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Telephone | 850-675-6666
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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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 | PH2540
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License Number State | FL
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