North Florida Pharmacy of Fort White Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PH22706 Issued in FL

Legal business name

NORTH FLORIDA PHARMACY OF FORT WHITE INC

Practice address

7729 SW US Highway 27
Fort White, FL 32038-3508

Phone

(386) 497-2580

Fax

(386) 497-4227

NPI assigned

Jun 14, 2007

Last updated

Aug 13, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Kathleen Marshall, PHARM.D., R.PH.NPI 1497941165

Title

Co-Owner, Pharmacy Manager

Phone

(352) 871-0819

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

• North Florida Pharmacy of Branford Inc

  • Community/Retail Pharmacy
  • Branford, FL
  • NPI 1316958069

  Member Of

  NPD member
• North Florida Pharmacy, Inc.

  • Community/Retail Pharmacy
  • Lake City, FL
  • NPI 1194734038

  Member Of

  NPD member

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kathleen Marshall, PHARM.D.

  • Pharmacist
  • Fort White, FL
  • NPI 1497941165
  NPD (past) Authorized official

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

{
    "created_epoch": "1181779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281657600000",
    "number": "1043414782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7729 SOUTHWEST US HIGHWAY 27",
            "city": "FORT WHITE",
            "state": "FL",
            "postal_code": "32038",
            "telephone_number": "386-497-2580",
            "fax_number": "386-497-4227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7729 SW US HIGHWAY 27",
            "city": "FORT WHITE",
            "state": "FL",
            "postal_code": "320383508",
            "telephone_number": "386-497-2580",
            "fax_number": "386-497-4227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH FLORIDA PHARMACY OF FORT WHITE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-14",
        "last_updated": "2010-08-13",
        "status": "A",
        "authorized_official_last_name": "MARSHALL",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "CO-OWNER, PHARMACY MANAGER",
        "authorized_official_telephone_number": "352-871-0819",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM.D., R.PH."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "FL",
            "license": "PH22706",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH22706",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "032073100",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "032073101",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maria's Support Coordination LLC
• Dianne Marroletti
• Kathleen Marshall, PHARM.D.
• Kaleah McCoy
• Maylenis Melian
• Physio-RX
• Sherrell Queen
• Caitlyn Richter, ATC
• Riverwood Alf Operating LLC (Our Home at Riverwood Lodge)
• Michele-Ann Colena Shaw, MS,CCC-SLP

• Community/Retail Pharmacy in Fort White, FL
• Providers in Fort White, FL by specialty
• Community/Retail Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2010; 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.

Verify at the official NPI Registry.