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BAYGREEN PHARMACY
NPI 1902170889
Pharmacy - Community/Retail Pharmacy in Jacksonville, FL

Active since February 24, 2012CLIA 10D2228011 · Waiver
9860 BEACH BLVD STE C, JACKSONVILLE, FL 32246(904) 201-8222(904) 297-4039 Get Directions Write a Review

NPPES record last updated: September 19, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 19, 2022, Feb 21, 2022, Nov 5, 2019 and 2 more (5 updates tracked since 2017).

About Baygreen Pharmacy NPPES

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

BAYGREEN PHARMACY (NPI 1902170889) is a healthcare organization registered as a community/retail pharmacy in Jacksonville, Florida and active in the NPI registry since February 2012. The organization holds a CLIA Waiver certificate valid through June 20, 2027 and lists Parul Mamtora, Director, as its authorized official.

NPPES Registry Identity

NPI1902170889
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameBAYGREEN PHARMACY CORP
Location Address9860 BEACH BLVD STE CJacksonville, FL 32246-4704
Mailing AddressPo Box 600316Jacksonville, FL 32260-0316 · (904) 201-8222 · Fax (904) 297-4039
Phone(904) 201-8222
Fax(904) 297-4039
Organization SubpartNo
Authorized OfficialParul MamtoraDirector · (904) 535-7514
Enumeration DateFebruary 24, 2012
Last NPPES UpdateSeptember 19, 20225 updates tracked since enumeration
NPPES CertifiedSeptember 19, 2022
✔ NPI 1902170889 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License✔ Licensed in FL · PH25960
Definition
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.
Also ListedPharmacyTaxonomy 333600000X
9860 BEACH BLVD STE C, Jacksonville, FL 32246
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Other Names 1

Doing Business AsBaygreen Pharmacy

Other Identifiers 2

Medicaid005613900FL
Other2133954Pk

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

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 Waiver 10D2228011

Baygreen Pharmacy · Jacksonville, FL
Active · expires Jun 20, 2027
CLIA Number10D2228011
Laboratory TypePharmacy
Certificate Effective DateJune 21, 2025
Certificate Expiration DateJune 20, 2027
Laboratory DirectorJudy Kommareddy
Laboratory Phone(904) 201-8222
Laboratory LocationBaygreen Pharmacy9860 Beach Blvd Ste C, Jacksonville, FL 32246
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. JUDY KOMMAREDDY PHARM D
Pharmacist
9860 BEACH BLVD STE C
JACKSONVILLE, FL 32246
Duval County (904) 201-8222

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 Baygreen Pharmacy Corp's NPI number?

The NPI number for Baygreen Pharmacy Corp is 1902170889. It was assigned to this organization in the NPPES registry on February 24, 2012. The provider is doing business as Baygreen Pharmacy.

Where is Baygreen Pharmacy Corp located?

Baygreen Pharmacy Corp is located at 9860 Beach Blvd Ste C, Jacksonville, FL 32246. The listed phone number is (904) 201-8222.

What is Baygreen Pharmacy Corp's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Does Baygreen Pharmacy Corp hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2228011) is associated with this NPI, valid through June 20, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Baygreen Pharmacy Corp accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arizona Complete Health and 46 other insurers list Baygreen Pharmacy Corp as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Baygreen Pharmacy Corp was last updated on September 19, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.