Provider Demographics
NPI:1780016709
Name:TOPICAL SPECIALISTS, LLC
Entity Type:Organization
Organization Name:TOPICAL SPECIALISTS, LLC
Other - Org Name:TOPICAL SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIR OF PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:RAKESH
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-886-2000
Mailing Address - Street 1:12276 SAN JOSE BLVD
Mailing Address - Street 2:STE 212
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32223-8628
Mailing Address - Country:US
Mailing Address - Phone:904-886-2000
Mailing Address - Fax:904-886-0002
Practice Address - Street 1:12276 SAN JOSE BLVD STE 212
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32223-8633
Practice Address - Country:US
Practice Address - Phone:904-886-2000
Practice Address - Fax:904-886-0002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-01
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH269773336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2141089OtherPK