Active NPI
Intergrated Pharmaceutical Solutions LLC
- Community/Retail Pharmacy
- Bartow, FL
National Provider Identifier
1013296649
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- PH25429
- Legal business name
- INTERGRATED PHARMACEUTICAL SOLUTIONS LLC
- Practice address
- 1478 N Wilson Ave
Bartow, FL 33830-3373 - Phone
- (863) 537-6694
- Fax
- (863) 537-6579
- NPI assigned
- Aug 14, 2011
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Enoch Ofosu, PHARM.D, M.D.
- Title
- Pharmacy Manager
- Phone
- (863) 537-6694
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | PH25429 | FL | Primary |
| Compounding Pharmacy | 3336C0004X |
Addresses
Primary practice location
1478 N Wilson Ave
Bartow, FL 33830-3373
Mailing address
PO Box 46216
Tampa, FL 33646-0102
Phone (863) 537-6694
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004112700 | Medicaid | FL | |
| PH25429 | Other | FL | PHARMACY LICENSE |
Other names 1
- Bartow Pharmacy & Medical Supply
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | info@bartowpharmacy.com | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240617003498 | FL | Part B Supplier - Pharmacy | 3971046046 | Practice locations: Bartow, FL |
National Provider Directory
National Provider Directory- Tax ID family
- Bartow Pharmacy Medical Supply
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- Bartow, FL
- NPI 1609691039
-
- Specialty Pharmacy
- Bartow, FL
- NPI 1750148375
Locations
1478 N Wilson Ave
Bartow, FL 33830
Phone (863) 537-6694
Networks
- Optimum HealthCare HMO Network
- Freedom Health HMO Network
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1313280000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1712880000000",
"number": "1013296649",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 46216",
"city": "TAMPA",
"state": "FL",
"postal_code": "336460102",
"telephone_number": "863-537-6694",
"fax_number": "863-537-6579"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1478 N WILSON AVE",
"city": "BARTOW",
"state": "FL",
"postal_code": "338303373",
"telephone_number": "863-537-6694",
"fax_number": "863-537-6579"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "INTERGRATED PHARMACEUTICAL SOLUTIONS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2011-08-14",
"last_updated": "2024-04-12",
"certification_date": "2024-04-12",
"status": "A",
"authorized_official_last_name": "OFOSU",
"authorized_official_first_name": "ENOCH",
"authorized_official_title_or_position": "PHARMACY MANAGER",
"authorized_official_telephone_number": "863-537-6694",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "PHARM.D, M.D."
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": false
},
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "FL",
"license": "PH25429",
"primary": true
},
{
"code": "3336C0004X",
"taxonomy_group": "",
"desc": "Pharmacy, Compounding Pharmacy",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "004112700",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACY LICENSE",
"identifier": "PH25429",
"state": "FL"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "info@bartowpharmacy.com",
"affiliation": "N",
"endpointDescription": "business email",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "1478 N Wilson Ave",
"city": "Bartow",
"state": "FL",
"country_code": "US",
"postal_code": "338303373",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"organization_name": "Bartow Pharmacy & Medical Supply",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Bartow Pharmacy & Medical Supply",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Bartow, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.