Provider Demographics
NPI:1326591066
Name:SPRX2 INC
Entity Type:Organization
Organization Name:SPRX2 INC
Other - Org Name:SPRX2
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:KERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:MCADOO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-503-5030
Mailing Address - Street 1:3740 SAINT JOHNS BLUFF RD S
Mailing Address - Street 2:SUITE 19
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32224-2651
Mailing Address - Country:US
Mailing Address - Phone:904-503-5030
Mailing Address - Fax:904-361-3866
Practice Address - Street 1:1201 MONUMENT RD STE 100
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32225-6445
Practice Address - Country:US
Practice Address - Phone:904-503-5030
Practice Address - Fax:904-361-3866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-29
Last Update Date:2016-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
FL302773336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2162477OtherPK