=====================================================
General NPI Number Information
=====================================================
NPI Number | 1992601827
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PHARMD FOR THEE LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/16/2026
-----------------------------------------------------
Last Update Date | 10/16/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 14132 WAVERLY FALLS LN W
-----------------------------------------------------
City | JACKSONVILLE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32224-5857
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 870-888-0627
-----------------------------------------------------
Fax | 870-888-0627
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 31255 TOOTSIE RD
-----------------------------------------------------
City | BUSH
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70431-4027
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 870-888-0627
-----------------------------------------------------
Fax | 870-888-0627
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | AMBR
-----------------------------------------------------
Name | RYAN COOK
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 870-888-0627
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------