Nimoh Pharmacy and Compounding LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PH28347 Issued in FL

Legal business name

NIMOH PHARMACY AND COMPOUNDING LLC

Doing business as

NIMOH PHARMACY AND COMPOUNDING
Nimoh Pharmacy and Compounding LLC
Nimoh Pharmacy and Compounidng

Practice address

12878 US Highway 301
Dade City, FL 33525-5801

Phone

(352) 437-5985

Fax

(352) 437-5986

NPI assigned

Jul 30, 2014

Organization subpart

No

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

Authorized official

Name

Daddy Nimoh Boateng, RPHNPI 1508135724

Title

P.I.C / Owner

Phone

(352) 437-5985

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 3

• NIMOH PHARMACY AND COMPOUNDING Doing business as
• Nimoh Pharmacy and Compounding LLC Doing business as
• Nimoh Pharmacy and Compounidng Doing business as

Locations

Networks

• Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Maximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
• Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Daddy Nimoh Boateng, PHARMD

  • Pharmacist
  • Dade City, FL
  • NPI 1508135724
  NPD Authorized official

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

{
    "created_epoch": "1406678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716940800000",
    "number": "1053729418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12878 US HIGHWAY 301",
            "city": "DADE CITY",
            "state": "FL",
            "postal_code": "335255801",
            "telephone_number": "352-437-5985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12878 US HIGHWAY 301",
            "city": "DADE CITY",
            "state": "FL",
            "postal_code": "335255801",
            "telephone_number": "352-437-5985",
            "fax_number": "352-437-5986"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12878 US Highway 301",
            "address_purpose": "LOCATION",
            "city": "Dade City",
            "state": "FL",
            "postal_code": "335255801",
            "country_code": "US",
            "telephone_number": "352-437-5985",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NIMOH PHARMACY AND COMPOUNDING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-30",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A",
        "authorized_official_last_name": "BOATENG",
        "authorized_official_first_name": "DADDY",
        "authorized_official_middle_name": "NIMOH",
        "authorized_official_title_or_position": "P.I.C / OWNER",
        "authorized_official_telephone_number": "352-437-5985",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH28347",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "012884100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NIMOH PHARMACY AND COMPOUNDING",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Nimoh Pharmacy and Compounding LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Nimoh Pharmacy and Compounidng",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Dade City, FL
• Providers in Dade City, 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 May 29, 2024; 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.