NPIMap

Organization Active NPI

Northeast Florida Health Services, Inc.

Doing business as Family Health Source

  • Community/Retail Pharmacy
  • Deland, FL
National Provider Identifier
1063903672
Registry record updated Jan 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
NORTHEAST FLORIDA HEALTH SERVICES, INC.
Doing business as
Family Health Source
Practice address
1205 S Woodland Blvd Ste 5
Deland, FL 32720-7464
Phone
(386) 202-6025
Fax
(386) 269-1847
NPI assigned
May 21, 2018
Organization subpart
Yes
Parent organization
NORTHEAST FLORIDA HEALTH SERVICES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 28, 2025

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

Authorized official

Name
Laurie Asbury
Title
Ceo
Phone
(386) 202-6025

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X FL Primary

Addresses

Primary practice location

1205 S Woodland Blvd Ste 5
Deland, FL 32720-7464

Mailing address

1205 S Woodland Blvd
Deland, FL 32720-7466
Phone (386) 202-6025

Other practice location 1

1200 Deltona Blvd
Deltona, FL 32725-6306
Phone (386) 202-6025

Other names 1

  • Family Health Source Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Northeast Florida Health11 organizations share this tax ID, including this one
Part of
Northeast Florida Health

Other organizations with this tax ID 10

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

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)

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": "1526860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738022400000",
    "number": "1063903672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 S WOODLAND BLVD",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327207466",
            "telephone_number": "386-202-6025",
            "fax_number": "386-269-1847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 S WOODLAND BLVD STE 5",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327207464",
            "telephone_number": "386-202-6025",
            "fax_number": "386-269-1847"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 Deltona Blvd",
            "address_purpose": "LOCATION",
            "city": "Deltona",
            "state": "FL",
            "postal_code": "327256306",
            "country_code": "US",
            "telephone_number": "386-202-6025",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NORTHEAST FLORIDA HEALTH SERVICES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTHEAST FLORIDA HEALTH SERVICES, INC.",
        "enumeration_date": "2018-05-21",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-28",
        "status": "A",
        "authorized_official_last_name": "ASBURY",
        "authorized_official_first_name": "LAURIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "386-202-6025"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Health Source",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Family Health Source",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Deland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2025; 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.