Medtown Pharmacy

LBN: Pich Ktm Corp
Medtown Pharmacy is an health care organization with primary practice located at 11643 Beach Blvd Unit A, Jacksonville FL 32246. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Community/Retail Pharmacy, Suppliers / Long Term Care Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Pich Ktm Corp can be contacted via phone (904) 551-5870, or through Oeur, Chen via phone (904) 551-5870.

Contact Information

Primary practice address
11643 Beach Blvd Unit A Jacksonville FL 32246
Fax: (904) 619-6227
Website:
Authorized official contact:
Name: Oeur, Chen RPH

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Community/Retail Pharmacy 3336C0003X
Suppliers / Long Term Care Pharmacy 3336L0003X

Profile Details

NPI number 1801354832
LBN Legal business name Pich Ktm Corp
DBA Doing business as Medtown Pharmacy
Authorized official Oeur, Chen RPH
Entity Organization
Organization subpart 1 No
Enumeration date Mar 8th, 2019
Last updated May 1st, 2023 - about last year

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801354832 NPPES
Florida MEDICAID 013879700

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