Provider Demographics
NPI:1861991895
Name:DENNINGS PHARMACY LLC
Entity type:Organization
Organization Name:DENNINGS PHARMACY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/MGR/PIC/AO
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DENNING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-652-4546
Mailing Address - Street 1:2620 BLANDING BLVD STE 2
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG
Mailing Address - State:FL
Mailing Address - Zip Code:32068-5175
Mailing Address - Country:US
Mailing Address - Phone:904-406-9379
Mailing Address - Fax:904-406-9157
Practice Address - Street 1:2620 BLANDING BLVD STE 2
Practice Address - Street 2:
Practice Address - City:MIDDLEBURG
Practice Address - State:FL
Practice Address - Zip Code:32068-5175
Practice Address - Country:US
Practice Address - Phone:904-406-9379
Practice Address - Fax:904-406-9157
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-05
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
FLPH311403336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2175798OtherPK