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General NPI Number Information
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NPI Number | 1528487303
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Entity Type | Organization
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Legal Business Name | COMPLETE CARE PHARMACY LLC
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Dates
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Enumeration Date | 04/09/2014
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Last Update Date | 02/28/2017
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Provider Practice Location Address
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Address Line | 7254 GOLDEN WINGS RD UNIT 9
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City | JACKSONVILLE
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State | FL
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Zip | 32244-3321
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Country | US
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Telephone | 904-389-1104
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Fax | 904-549-5631
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Provider Business Mailing Address
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Address Line | COMPLETE CARE PHARMACY 7254 GOLDEN WINGS RD SUITE 9
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City | JACKSONVILLE
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State | FL
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Zip | 32244
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Country | US
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Telephone | 904-389-1104
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Fax | 904-549-5631
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | KATIE PATEL
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Credential |
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Telephone | 904-389-1104
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding 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 | PH28288
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License Number State | FL
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