Organization Active NPI

RX Healthcare System LLC

Doing business as Community Pharmacy of Port Orange

  • Community/Retail Pharmacy
  • Port Orange, FL
National Provider Identifier
1093230831
Registry record updated Aug 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PH30903 Issued in FL
Legal business name
RX HEALTHCARE SYSTEM LLC
Doing business as
Community Pharmacy of Port Orange
Practice address
3755 S Nova Rd Ste a
Port Orange, FL 32129-4282
Phone
(321) 946-6332
NPI assigned
Aug 12, 2017
Last updated
Aug 12, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2017

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

Authorized official

Name
Kalpeshkumar C Patel, PHARMACISTNPI 1255867446
Title
Owner
Phone
(321) 946-6332

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PH30903 FL Primary

Addresses

Primary practice location

3755 S Nova Rd Ste a
Port Orange, FL 32129-4282

Mailing address

3755 South Nova Road
Unit# a
Port Orange, FL 32129
Phone (321) 946-6332

Other names 1

  • COMMUNITY PHARMACY OF PORT ORANGE Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190114000403 FL Part B Supplier - Mass Immunization (Roster Biller Only) 8325384357 Practice locations: Port Orange, FL

National Provider Directory

National Provider Directory

Locations

3755 S Nova Rd
Ste A
Port Orange, FL 32129
Phone (321) 946-6332

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 Máximo (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 & affiliated clinicians

Practitioners 1

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": "1502496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1502496000000",
    "number": "1093230831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3755 SOUTH NOVA ROAD",
            "address_2": "UNIT# A",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "32129",
            "telephone_number": "321-946-6332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3755 S NOVA RD STE A",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321294282",
            "telephone_number": "321-946-6332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RX HEALTHCARE SYSTEM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-12",
        "last_updated": "2017-08-12",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "KALPESHKUMAR",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "321-946-6332",
        "authorized_official_credential": "PHARMACIST"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH30903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COMMUNITY PHARMACY OF PORT ORANGE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Port Orange, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.