NPIMap

Organization Active NPI

Commcare Pharmacy Mia LLC

Doing business as Commcare Pharmacy Mia

  • Specialty Pharmacy
  • Miami, FL
National Provider Identifier
1063423606
Registry record updated Jun 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Specialty PharmacyTaxonomy code 3336S0011X
License
PH21974 Issued in FL
Legal business name
COMMCARE PHARMACY MIA LLC
Doing business as
Commcare Pharmacy Mia
Practice address
1801 Coral Way
Ste 115
Miami, FL 33145-2790
Phone
(305) 854-5535
Fax
(305) 854-5929
NPI assigned
Aug 10, 2006
Last updated
Jun 20, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2016

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

Authorized official

Name
Richard Dougherty
Title
Coo
Phone
(954) 332-6170

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X
Specialty Pharmacy 3336S0011X PH21974 FL Primary

Addresses

Primary practice location

1801 Coral Way
Ste 115
Miami, FL 33145-2790

Mailing address

855 SW 78TH Ave
Ste C100
Plantation, FL 33324-3223
Phone (954) 568-6212

Other identifiers 2

IdentifierTypeStateIssuer
031649100MedicaidFL
2006806OtherPK

Other names 1

  • COMMCARE PHARMACY MIA Doing business as

National Provider Directory

National Provider Directory

Member of 1

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

  • Dignity Health

    dba Mercy Gilbert Medical Center

    • General Acute Care Hospital
    • Gilbert, AZ
    • NPI 1992735088

    Member Of

    NPD member

Member organizations 4

Organizations listed as members of this organization in the National Provider Directory.

Locations

1801 Coral Way
Ste 115
Miami, FL 33145
Phone (305) 854-5535

855 SW 78th Ave
Ste C100
Plantation, FL 33324
Phone (954) 568-6212

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466380800000",
    "number": "1063423606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 SW 78TH AVE",
            "address_2": "STE C100",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333243223",
            "telephone_number": "954-568-6212",
            "fax_number": "954-568-2765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 CORAL WAY",
            "address_2": "STE 115",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331452790",
            "telephone_number": "305-854-5535",
            "fax_number": "305-854-5929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMCARE PHARMACY MIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "last_updated": "2016-06-20",
        "status": "A",
        "authorized_official_last_name": "DOUGHERTY",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "954-332-6170"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "FL",
            "license": "PH21974",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "031649100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2006806",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COMMCARE PHARMACY MIA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2016; 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.