Organization
BANYANITES - 2 LLC
Active
Organization
BANYANITES - 2 LLC
Active
Other names
BENZER PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MANAN PATEL (OWNER,PRESIDENT,AO)
(904) 814-5933
Entity
Organization
Contact information
Practice address
11048 BAYMEADOWS RD UNIT 5, JACKSONVILLE, FL 32256-9583
(904) 240-1101
(904) 204-1128
Mailing address
11048 BAYMEADOWS RD UNIT 5, JACKSONVILLE, FL 32256-9583
(904) 240-1101
(904) 204-1128
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH31057
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2174467
PK
—
Enumeration date
11/30/2017
Last updated
05/04/2018
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