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General NPI Number Information
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NPI Number | 1750416202
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Entity Type | Organization
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Legal Business Name | JAY PHARMACY OF JAY,FLA INC
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Dates
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Enumeration Date | 02/23/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 14088 ALA ST
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City | JAY
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State | FL
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Zip | 32565
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Country | US
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Telephone | 859-675-6666
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Fax | 850-675-4666
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Provider Business Mailing Address
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Address Line | 14088 ALA ST PO BOX 367
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City | JAY
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State | FL
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Zip | 32565
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Country | US
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Telephone | 859-675-6666
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Fax | 850-675-4666
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. CECIL ROBERT PHILLIPSRPHR
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Credential | RPH
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Telephone | 18506756666
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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 | PH2540
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License Number State | FL
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