Heartland Pharmacy Lake Placid Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

PH26570 Issued in FL

Legal business name

HEARTLAND PHARMACY LAKE PLACID INC

Practice address

342 E Royal Palm St
Lake Placid, FL 33852-5019

Phone

(863) 659-1780

Fax

(863) 659-1786

NPI assigned

Jan 10, 2017

Organization subpart

No

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

Authorized official

Name

Carin Duncan Bralts, PHARMD

Title

President

Phone

(863) 449-1006

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Heartland Pharmacy Lake Placid2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Heartland Pharmacy Lake Placid Inc

  • Long Term Care Pharmacy
  • Lake Placid, FL
  • NPI 1306584156
  NPD tax ID

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

{
    "created_epoch": "1484006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484006400000",
    "number": "1063958437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "342 E ROYAL PALM ST",
            "city": "LAKE PLACID",
            "state": "FL",
            "postal_code": "338525019",
            "telephone_number": "863-659-1780",
            "fax_number": "863-659-1786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "342 E ROYAL PALM ST",
            "city": "LAKE PLACID",
            "state": "FL",
            "postal_code": "338525019",
            "telephone_number": "863-659-1780",
            "fax_number": "863-659-1786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEARTLAND PHARMACY LAKE PLACID INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-10",
        "last_updated": "2017-01-10",
        "status": "A",
        "authorized_official_last_name": "BRALTS",
        "authorized_official_first_name": "CARIN",
        "authorized_official_middle_name": "DUNCAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "863-449-1006",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "FL",
            "license": "PH26570",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008053901",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Healthnomics LLC
• Heartland Medical Supply Inc
• Heartland Medical Supply Inc
• Heartland Pediatrics of Lake Placid, Inc.
• Heartland Pharmacy Lake Placid
• Heartland Pharmacy Lake Placid Inc
• Michael James Henry, DO
• Gallardo De Grano Hermoso, PT
• Lydeliz Hernandez Perez
• Milagros Socooro Hernandez

• Durable Medical Equipment & Medical Supplies in Lake Placid, FL
• Providers in Lake Placid, FL by specialty
• Durable Medical Equipment & Medical Supplies in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2017; 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.