SHANDS JACKSONVILLE PLAZA PHARMACY
NPI 1073604914
Durable Medical Equipment & Medical Supplies in Jacksonville, FL

Q: What is Shands Jacksonville Medical Center Inc's specialty?

The primary specialty registered for this NPI is Durable Medical Equipment & Medical Supplies with taxonomy code 332B00000X.

Active since September 27, 2006CLIA Certified · 2 labs

580 W 8TH ST # 2, JACKSONVILLE, FL 32209(904) 244-9162(904) 244-9166 Get Directions Write a Review

NPPES record last updated: July 22, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Shands Jacksonville Plaza Pharmacy NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHANDS JACKSONVILLE PLAZA PHARMACY (NPI 1073604914) is a healthcare organization registered as a durable medical equipment & medical supplies in Jacksonville, Florida and active in the NPI registry since September 2006. The organization holds 2 active CLIA laboratory certificates and lists Michael E Gleason, Vp Of Finance And Treasurer, as its authorized official.

NPPES Registry Identity

NPI1073604914

Entity TypeOrganization

Primary Taxonomy332B00000X

Legal Business NameSHANDS JACKSONVILLE MEDICAL CENTER INC

Location Address580 W 8TH ST # 2Jacksonville, FL 32209-6533

Mailing Address655 W 8th StJacksonville, FL 32209-6511 · (904) 244-8675 · Fax (904) 244-4027

Phone(904) 244-9162

Fax(904) 244-9166

Organization SubpartYesParent: Shands Jacksonville Medical Center, Inc.

Authorized OfficialMichael E GleasonVp Of Finance And Treasurer · (904) 244-8675

Enumeration DateSeptember 27, 2006

Last NPPES UpdateJuly 22, 2024

NPPES CertifiedJuly 22, 2024

✔ NPI 1073604914 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDurable Medical Equipment & Medical SuppliesSuppliers

Taxonomy Code332B00000X

License✔ Licensed in FL · PH21850

Definition

A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.

580 W 8TH ST # 2, Jacksonville, FL 32209

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Other Names 1

Doing Business AsShands Jacksonville Plaza Pharmacy

Other Identifiers 1

Medicaid031291601FL

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Accreditation 10D0268926

Shands Jacksonville Medical Center · Jacksonville, FL

Active · expires Feb 27, 2027

CLIA Number10D0268926

Laboratory TypeHospital

Certificate Effective DateFebruary 28, 2025

Certificate Expiration DateFebruary 27, 2027

Laboratory DirectorDr. Shahla Masood

Laboratory Phone(904) 244-6052

Laboratory LocationShands Jacksonville Medical Center655 W 8th Street Rm 1-041 1st Floor Lab Administration, Jacksonville, FL 32209

CLIA data matches this NPI record on: Address Name

This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Certificate of Waiver 10D1015763

Shands Jacksonville-Waive Nursing · Jacksonville, FL

Active · expires Aug 11, 2027

CLIA Number10D1015763

Laboratory TypeHospital

Certificate Effective DateAugust 12, 2025

Certificate Expiration DateAugust 11, 2027

Laboratory DirectorMatthew Feldhammer

Laboratory Phone(904) 244-7768

Laboratory LocationShands Jacksonville-Waive Nursing655 W 8th St Rm 1-041 1st Floor Lab Administration, Jacksonville, FL 32209

CLIA data matches this NPI record on: Address

This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shands Jacksonville Medical Center Inc's NPI number?

The NPI number for Shands Jacksonville Medical Center Inc is 1073604914. It was assigned to this organization in the NPPES registry on September 27, 2006. The provider is doing business as Shands Jacksonville Plaza Pharmacy.

Where is Shands Jacksonville Medical Center Inc located?

Shands Jacksonville Medical Center Inc is located at 580 W 8th St # 2, Jacksonville, FL 32209. The listed phone number is (904) 244-9162.

What is Shands Jacksonville Medical Center Inc's specialty?

The primary specialty registered for this NPI is Durable Medical Equipment & Medical Supplies with taxonomy code 332B00000X.

Does Shands Jacksonville Medical Center Inc hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Shands Jacksonville Medical Center Inc was last updated on July 22, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.