NPIMap

Organization Active NPI

My Pharmacy Crystal River, LLC

  • Family Medicine Physician
  • Crystal River, FL
National Provider Identifier
1033837307
Registry record updated Aug 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MY PHARMACY CRYSTAL RIVER, LLC
Practice address
927 N Citrus Ave
Crystal River, FL 34428
Phone
(352) 565-7342
Fax
(352) 565-5880
NPI assigned
Aug 22, 2022
Organization subpart
Yes
Parent organization
MY PHARMACY CRYSTAL RIVER, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 22, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Brian Branham
Title
VP of Finance & Sales
Phone
(321) 221-0658

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

927 N Citrus Ave
Crystal River, FL 34428

Mailing address

2710 Rew Circle Suite 200
Ocoee, FL 34761
Phone (407) 654-5414

Other names 1

  • Citrus Crystal River Doing business as

National Provider Directory

National Provider Directory
Tax ID family
My Pharmacy Crystal River LLC8 organizations share this tax ID, including this one
Part of
My Pharmacy Crystal River LLC

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1661126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661126400000",
    "number": "1033837307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2710 REW CIRCLE SUITE 200",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "34761",
            "telephone_number": "407-654-5414",
            "fax_number": "407-654-9614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "927 N CITRUS AVE",
            "city": "CRYSTAL RIVER",
            "state": "FL",
            "postal_code": "34428",
            "telephone_number": "352-565-7342",
            "fax_number": "352-565-5880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY PHARMACY CRYSTAL RIVER, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MY PHARMACY CRYSTAL RIVER, LLC",
        "enumeration_date": "2022-08-22",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-22",
        "status": "A",
        "authorized_official_last_name": "BRANHAM",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "VP OF FINANCE & SALES",
        "authorized_official_telephone_number": "321-221-0658"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Citrus Crystal River",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Crystal River, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.