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General NPI Number Information
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NPI Number | 1881998938
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Entity Type | Organization
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Legal Business Name | JAI MARUTI RX LLC
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Dates
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Enumeration Date | 01/04/2011
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Last Update Date | 02/28/2017
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Provider Practice Location Address
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Address Line | 9323 LEM TURNER RD
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City | JACKSONVILLE
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State | FL
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Zip | 32208-2274
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Country | US
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Telephone | 904-222-8490
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Fax | 904-222-8495
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Provider Business Mailing Address
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Address Line | 9323 LEM TURNER RD
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City | JACKSONVILLE
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State | FL
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Zip | 32208-2274
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Country | US
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Telephone | 904-222-8490
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Fax | 904-222-8495
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Authorized Official
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Title or Position | PHARMACY MANAGER
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Name | KAVIN PATEL
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Credential |
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Telephone | 904-955-3460
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PH25157
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License Number State | FL
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