Provider Demographics
NPI:1033565585
Name:NEW LYNK, LLC
Entity Type:Organization
Organization Name:NEW LYNK, LLC
Other - Org Name:E- LYNK PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:EMMANUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DORVLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-374-9334
Mailing Address - Street 1:5800 BEACH BLVD STE 105
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32207-5180
Mailing Address - Country:US
Mailing Address - Phone:904-374-9334
Mailing Address - Fax:904-374-9309
Practice Address - Street 1:5800 BEACH BLVD STE 105
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-5180
Practice Address - Country:US
Practice Address - Phone:904-374-9334
Practice Address - Fax:904-374-9309
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-13
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH301203336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL019153500Medicaid