Active NPI
Sally Wilson, RPH
- Pharmacist
- Winter Haven, FL
National Provider Identifier
1093354847
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS24455
- Practice address
- 7450 Cypress Gardens Blvd
Winter Haven, FL 33884-6200 - Phone
- (863) 318-0252
- Fax
- (863) 318-0282
- NPI assigned
- Dec 26, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS24455 | FL | Primary |
Addresses
Primary practice location
7450 Cypress Gardens Blvd
Winter Haven, FL 33884-6200
Mailing address
210 Hibriten Way
Lakeland, FL 33803-2224
Phone (863) 670-7618
Other names 1
- Sally Wilson Perry
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS24455 | FL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1577318400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1577318400000",
"number": "1093354847",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "210 HIBRITEN WAY",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338032224",
"telephone_number": "863-670-7618"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7450 CYPRESS GARDENS BLVD",
"city": "WINTER HAVEN",
"state": "FL",
"postal_code": "338846200",
"telephone_number": "863-318-0252",
"fax_number": "863-318-0282"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "SALLY",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-12-26",
"last_updated": "2019-12-26",
"certification_date": "2019-12-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS24455",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SALLY",
"last_name": "PERRY",
"middle_name": "WILSON",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Winter Haven, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.