MEDICARE: DR. CRYSTAL B MAGUIRE PHARMD, CPH

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	183500000X	Pharmacist	PS47890	FL

General Provider Information

NPI Number	:	1467055756
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CRYSTAL B MAGUIRE PHARMD, CPH

Provider Business Mailing Address
First Line	:	4237 SALISBURY RD STE 301
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-0908
Country	:	US
Telephone Number	:	904-683-4298
Fax Number	:	904-683-4922

Provider Business Practice Location Address
First Line	:	4237 SALISBURY RD STE 301
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-0908
Country	:	US
Telephone Number	:	904-683-4298
Fax Number	:	904-683-4922

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/18/2020
Last Update Date	:	12/30/2021

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