Provider Demographics
NPI:1356646376
Name:PHARMACY PLUS INC
Entity Type:Organization
Organization Name:PHARMACY PLUS INC
Other - Org Name:PHARMACY PLUS, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AMJAD
Authorized Official - Middle Name:
Authorized Official - Last Name:NIMRI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-442-8822
Mailing Address - Street 1:7645 MERRILL RD STE 210
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32277-6574
Mailing Address - Country:US
Mailing Address - Phone:904-442-8822
Mailing Address - Fax:904-442-7878
Practice Address - Street 1:7645 MERRILL RD STE 210
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32277-6574
Practice Address - Country:US
Practice Address - Phone:904-442-8822
Practice Address - Fax:904-442-7878
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-22
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH252013336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
5704603OtherNCPDP PROVIDER IDENTIFICATION NUMBER