Organization
SHANDS JACKSONVILLE MEDICAL CENTER INC
Active
Parent organization
SHANDS JACKSONVILLE MEDICAL CENTER, INC.
Other names
Shands Jacksonville Ambulatory Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
SHANDS JACKSONVILLE MEDICAL CENTER, INC.
Authorized official
MR. DEAN COCCHI (VICE PRESIDENT AND CFO OF FINANCE)
(904) 244-5013
Entity
Organization
Contact information
Practice address
655 W 8TH ST, 1ST FLOOR, ACC BLDG., JACKSONVILLE, FL 32209-6511
(904) 244-4542
(904) 244-4998
Mailing address
655 W 8TH ST, JACKSONVILLE, FL 32209-6511
(904) 244-8675
(904) 244-4027
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0217042-00
—
FL
01
—
1029164
NCPDP
—
01
—
PH16886
PHARMACY LICENSE NUMBER
FL
Enumeration date
10/10/2006
Last updated
07/22/2024
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