PUBLIC SQUARE PHARMACY LLC (NPI# 1992273023) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1992273023 |
Entity Type | Organization |
Organization Name | PUBLIC SQUARE PHARMACY LLC |
Practice Address |
11757 Beach Blvd Ste 7 Jacksonville FL 32246-6633 |
Mailing Address |
7836 Timberlin Park Blvd Jacksonville FL 32256-5413 |
Practice Telephone | 9412041610 |
Practice Fax Number | 9043767718 |
Mailing Telephone | 9412041610 |
Enumeration Date | 2018-11-07 |
Last Update Date | 2018-11-07 |
Authorized Official Name | DIEGO GOMEZ (OWNER PHARMACY MANAGER) |
Authorized Official Telephone | 9412041610 |
Authorized Official Credential | PHARM. D. |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
Other Name | Type Code |
---|---|
Public Square Pharmacy | Doing Business As Name - Organization |
Street Address |
11757 BEACH BLVD STE 7 |
City | JACKSONVILLE |
State | FL |
Zip Code | 32246-6633 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1356941348 | Diego Gomez | Pharmacist | 11757 Beach Blvd Ste 7, Jacksonville, FL 32246-6633 | 2020-10-28 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1275179863 | Samar A Ibrahim | Pharmacist | 1305 N Orange Ave Green Cove Springs, Jacksonville, FL 32246 | 2019-11-19 |
1386290898 | Kelsey R Clevenger | Chiropractor | 4413 Town Center Parkway, Ste. 205, Jacksonville, FL 32246 | 2019-08-12 |
1700449006 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 4712 Lake Center Drive, Space 107, Jacksonville, FL 32246 | 2019-04-22 |
1205399946 | Usa United Surgical Assistants | Clinic/Center | Bahri Surgical Center, 9726 Touchton Rd, Jacksonville, FL 32246 | 2019-04-10 |
1780173526 | Jules Novall LLC | Taxi | 4600 Touchton Rd, Jacksonville, FL 32246 | 2018-05-08 |
1740636307 | Jonathan David Browning | Psychiatry & Neurology | 4884 Deer Creek Drive W, Jacksonville, FL 32246 | 2016-05-12 |
1952770463 | Alignment Healthcare Florida LLC | Clinic/Center | 3520-1 St. Johns Bluff Rd., Jacksonville, FL 32246 | 2015-09-15 |
1558739417 | Jessica Brake | Physical Therapist | 9726 Touchton Road, Suite 104, Jacksonville, FL 32246 | 2015-09-09 |
1043686256 | Healthyeye Dba Vision Express LLC | Optometrist | 4871 Town Center Parkway #5, Jacksonville, FL 32246 | 2015-08-12 |
1477954675 | Joanivette Rodriguez | Psychologist | 3451 Saland Way Apt 504, Jacksonville, FL 32246 | 2014-09-08 |
Find all providers in zip 32246 |
Taxonomy Code | 3336C0003X |
Grouping | Suppliers |
Classification | Pharmacy |
Specialization | Community/Retail Pharmacy |
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1285281071 | Sharshon Pharmacy Inc | Pharmacy | 154 W Morton Ave, Jacksonville, IL 62650 | 2019-08-26 |
1275191983 | University Pharmacy of Jacksonville, Inc | Pharmacy | 3901 University Blvd S Ste 237, Jacksonville, FL 32216-4390 | 2019-05-29 |
1841707940 | Excel Pharmacy Partners LLC | Pharmacy | 6817 Southpoint Pkwy Ste 2204, Jacksonville, FL 32216-8200 | 2018-01-10 |
1144735556 | Costco Wholesale Corporation | Pharmacy | 8000 Parramore Rd, Jacksonville, FL 32244 | 2017-12-07 |
1912418286 | Av 1 Pharma LLC | Pharmacy | 1539 University Blvd N, Jacksonville, FL 32211-5229 | 2017-10-13 |
1629589908 | A V 2 Pharma LLC | Pharmacy | 1537 University Blvd N # Dn, Jacksonville, FL 32211-5229 | 2017-10-13 |
1881117109 | Summit Vision Inc. | Pharmacy | 3416 Moncrief Rd Ste 101, Jacksonville, FL 32209-4340 | 2017-07-18 |
1316486525 | Smart Pharmacy Inc | Pharmacy | 14003 Beach Blvd # 1, Jacksonville, FL 32250-1541 | 2017-02-21 |
1033565585 | New Lynk, LLC | Pharmacy | 5800 Beach Blvd Ste 105, Jacksonville, FL 32207-5180 | 2016-05-13 |
1316315393 | Benzer Fl 10 LLC | Pharmacy | 11048 Baymeadows Road, Suite 5, Jacksonville, FL 32256 | 2015-09-09 |
Find all providers in JACKSONVILLE |
City | JACKSONVILLE |
Zip Code | 32246 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.