Organization
MARIETTA PHARMACY LLC
Active
Other names
MARIETTA PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
HANESH PATEL (RXM)
(904) 999-4884
Entity
Organization
Contact information
Practice address
8299 W BEAVER ST STE 5, JACKSONVILLE, FL 32220-2315
(904) 999-4884
(904) 999-4883
Mailing address
8299 W BEAVER ST STE 5, JACKSONVILLE, FL 32220-2315
(904) 999-4884
(904) 999-4883
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH26285
FL
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007212200
—
FL
01
—
5711189
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
07/31/2012
Last updated
02/24/2022
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us