MEDICARE: JONES TOTAL HEALTH PHARMACY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy	PH24340	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2122730	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154658169
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JONES TOTAL HEALTH PHARMACY LLC

Provider Business Mailing Address
First Line	:	401 E LAS OLAS BLVD
Second Line	:	SUITE 130-376
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33301-2210
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1130 W SUNRISE BLVD
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33311-7165
Country	:	US
Telephone Number	:	954-533-1244
Fax Number	:	954-306-6905

Authorized Official
Title or Position	:	OWNER
Name	:	CHERESE JONES
Credential	:
Telephone Number	:	904-613-2258

Provider Enumeration Date	:	11/11/2009
Last Update Date	:	10/12/2023

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