Acariahealth Pharmacy #26, Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PH22669 Issued in FL

Legal business name

ACARIAHEALTH PHARMACY #26, INC.

Practice address

8715 Henderson Rd
Tampa, FL 33634-1143

Phone

(866) 458-9246

Fax

(866) 458-9245

NPI assigned

Apr 26, 2007

Organization subpart

Yes

Parent organization

ACARIAHEALTH, INC.As reported in NPPES

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

Authorized official

Name

Jessica Dawn Ciccolella-Kahl

Title

President

Phone

(855) 422-2742

Specialties & licenses 2

Addresses

Other identifiers 23

Other names 1

• WellCare Specialty Pharmacy, Inc. Former legal business name

Medicare fee-for-service enrollment

Enrolled in FL2 enrollments

Enrollment records 2

Member of 1

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

• Wellcare, Inc.

  • Home Health Agency
  • Roswell, NM
  • NPI 1639367998

  Member Of

  NPD member

Locations

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

• Lisa Hogan, PHARM D

  • Pharmacist
  • Tampa, FL
  • NPI 1104406628
  NPD
• Valerie Gail Mugavero, RPH

  • Pharmacist
  • Tampa, FL
  • NPI 1154052546
  NPD

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707436800000",
    "number": "1073733408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8715 HENDERSON RD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336341143",
            "telephone_number": "866-458-9246",
            "fax_number": "886-458-9245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8715 HENDERSON RD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336341143",
            "telephone_number": "866-458-9246",
            "fax_number": "866-458-9245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACARIAHEALTH PHARMACY #26, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ACARIAHEALTH, INC.",
        "enumeration_date": "2007-04-26",
        "last_updated": "2024-02-09",
        "certification_date": "2024-02-07",
        "status": "A",
        "authorized_official_last_name": "CICCOLELLA-KAHL",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "DAWN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "855-422-2742"
    },
    "taxonomies": [
        {
            "code": "251F00000X",
            "taxonomy_group": "",
            "desc": "Home Infusion",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH22669",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1073733408",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY LICENSE",
            "identifier": "PH22669",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1073733408",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1073733408",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3014228",
            "state": "UT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3128603",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0387550",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05743811",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10026581500",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1073733408",
            "state": "HI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1073733408",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1073733408",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7F2669",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "241842",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100220090",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103767416",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1073733408",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300038102",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "032112500",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2157757",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1073733408",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500778781",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "582077",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WellCare Specialty Pharmacy, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• All providers in Tampa, FL
• Community/Retail Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.