Provider Demographics
NPI:1104375971
Name:TROX PHARMACY, LLC
Entity Type:Organization
Organization Name:TROX PHARMACY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:TROXELL
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:904-500-8769
Mailing Address - Street 1:14965 OLD SAINT AUGUSTINE RD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32258-9480
Mailing Address - Country:US
Mailing Address - Phone:904-500-8769
Mailing Address - Fax:904-500-8770
Practice Address - Street 1:14965 OLD SAINT AUGUSTINE RD
Practice Address - Street 2:SUITE 108
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32258-9480
Practice Address - Country:US
Practice Address - Phone:904-500-8769
Practice Address - Fax:904-500-8770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-22
Last Update Date:2016-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH303673336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy