NPIMap

Organization Active NPI

Medline Enterprises Inc

  • Pharmacy
  • Tampa, FL
National Provider Identifier
1093940496
Registry record updated Dec 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
PH23943 Issued in FL
Legal business name
MEDLINE ENTERPRISES INC
Practice address
3336 S Dale Mabry Hwy
Tampa, FL 33629-7840
Phone
(813) 832-5151
Fax
(727) 489-9489
NPI assigned
May 29, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2010

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

Authorized official

Name
King Yeotan
Title
D
Phone
(813) 494-0458

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X PH23943 FL Primary

Addresses

Primary practice location

3336 S Dale Mabry Hwy
Tampa, FL 33629-7840

Mailing address

3336 S Dale Mabry Hwy
Tampa, FL 33629-7840
Phone (813) 832-5151

Other identifiers 1

IdentifierTypeStateIssuer
1045702OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • promed pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Medline Enterprises Inc2 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.

NPI Registry JSON

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

{
    "created_epoch": "1243555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291334400000",
    "number": "1093940496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3336 S DALE MABRY HWY",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336297840",
            "telephone_number": "813-832-5151",
            "fax_number": "727-489-9489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3336 S DALE MABRY HWY",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336297840",
            "telephone_number": "813-832-5151",
            "fax_number": "727-489-9489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDLINE ENTERPRISES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-29",
        "last_updated": "2010-12-03",
        "status": "A",
        "authorized_official_last_name": "YEOTAN",
        "authorized_official_first_name": "KING",
        "authorized_official_title_or_position": "D",
        "authorized_official_telephone_number": "813-494-0458"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "FL",
            "license": "PH23943",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "1045702",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "promed pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2010; 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.