Organization
JESSIE TRICE COMMUNITY HEALTH SYSTEM, INC
Active
Other names
BARBARA J. JORDAN PHARMACY, Barbara Jordan Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN R. HAWKINS (PRESIDENT & CEO)
(305) 805-1700
Entity
Organization
Contact information
Practice address
20612 NW 27TH AVENUE, MIAMI GARDENS, FL 33056
(305) 835-1615
(305) 474-7004
Mailing address
5607 NW 27TH AVENUE, SUITE 1, MIAMI, FL 33142
(305) 499-1928
(305) 634-1845
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
113009000
—
FL
01
—
PH33678
STATE LICENSE NUMBER
FL
Enumeration date
12/22/2021
Last updated
08/06/2025
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