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Organization

SPRING PARK PHARMACY LLC

Active
Other names
Spring Park Pharmacy
Organization subpart
No

Provider details

NPI number
Authorized official
STACY CHAO (PHARMACIST IN CHARGE)
(904) 551-5094
Entity
Organization

Contact information

Practice address
3851 EMERSON ST STE 13, JACKSONVILLE, FL 32207
(904) 551-5094
(904) 527-1244
Mailing address
4446 HENDRICKS AVE STE 408, JACKSONVILLE, FL 32207-6369
(904) 551-5094
(904) 527-1244

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
332BN1400X
Nursing Facility Supplies (DME)
333600000X
Pharmacy
Primary
PH31080
FL
3336C0003X
Community/Retail Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2175032
PK
Enumeration date
12/12/2017
Last updated
07/16/2018
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