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General NPI Number Information
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NPI Number | 1689569550
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Entity Type | Organization
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Legal Business Name | CAPSTONE HEALTH JACKSONVILLE, LLC
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Dates
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Enumeration Date | 06/11/2025
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Last Update Date | 06/11/2025
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Provider Practice Location Address
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Address Line | 80 PINNACLES DR STE 900
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City | PALM COAST
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State | FL
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Zip | 32164-2915
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Country | US
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Telephone | 386-477-0010
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Fax | 386-477-0011
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Provider Business Mailing Address
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Address Line | 80 PINNACLES DR STE 900
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City | PALM COAST
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State | FL
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Zip | 32164-2915
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Country | US
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Telephone | 386-477-0010
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Fax | 386-477-0011
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Authorized Official
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Title or Position | OWNER
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Name | BRAD J. MANNING
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Credential |
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Telephone | 386-477-0010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251F00000X
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Taxonomy Name | Home Infusion Agency
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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 | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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License Number |
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License Number State |
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Taxonomy #4
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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 #5
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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 #6
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Taxonomy Code | 3336H0001X
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Taxonomy Name | Home Infusion Therapy Pharmacy
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License Number |
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License Number State |
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