Organization
BEACHES PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL MAYO PHARMD, RPH (PHARMACIST)
(850) 545-7646
Entity
Organization
Contact information
Practice address
4717 SAN JUAN AVE UNIT 1, JACKSONVILLE, FL 32210-3229
(850) 545-7646
Mailing address
4320 DEERWOOD LAKE PKWY STE 101-211, JACKSONVILLE, FL 32216-1177
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PS43165
FL
Other
Enumeration date
10/01/2010
Last updated
10/01/2010
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