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General NPI Number Information
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NPI Number | 1548920143
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Entity Type | Organization
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Legal Business Name | JESSIE TRICE COMMUNITY HEALTH SYSTEM, INC
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Dates
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Enumeration Date | 12/22/2021
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Last Update Date | 08/06/2025
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Provider Practice Location Address
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Address Line | 20612 NW 27TH AVENUE
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City | MIAMI GARDENS
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State | FL
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Zip | 33056
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Country | US
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Telephone | 305-835-1615
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Fax | 305-474-7004
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Provider Business Mailing Address
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Address Line | 5607 NW 27TH AVENUE SUITE 1
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City | MIAMI
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State | FL
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Zip | 33142
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Country | US
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Telephone | 305-499-1928
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Fax | 305-634-1845
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Authorized Official
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Title or Position | PRESIDENT & CEO
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Name | RYAN R. HAWKINS
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Credential |
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Telephone | 305-805-1700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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