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General NPI Number Information
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NPI Number | 1841926094
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Entity Type | Organization
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Legal Business Name | BLUEBIRD SPECIALTY PHARMACY LLC
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Dates
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Enumeration Date | 07/29/2022
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Last Update Date | 07/29/2022
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Provider Practice Location Address
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Address Line | 8110 CYPRESS PLAZA DR STE 301
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City | JACKSONVILLE
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State | FL
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Zip | 32256-4468
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Country | US
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Telephone | 704-804-3600
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Fax |
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Provider Business Mailing Address
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Address Line | 9158 STARPASS DR
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City | JACKSONVILLE
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State | FL
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Zip | 32256-5474
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | ANNA MOYER
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Credential | PHARM.D.
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Telephone | 704-804-3600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #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 | 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 #4
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty 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 | 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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