Prohealth Pharmacy Solutions, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PH29369 Issued in FL

Legal business name

PROHEALTH PHARMACY SOLUTIONS, LLC

Practice address

500 Winderley PL Ste 226
Maitland, FL 32751-7407

Phone

(321) 527-7940

Fax

(407) 670-0428

NPI assigned

Jul 12, 2018

Organization subpart

No

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

Authorized official

Name

Kathleen Patrick

Title

President

Phone

(412) 733-1910

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1531353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675036800000",
    "number": "1104302215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 WINDERLEY PL STE 228",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327517407",
            "telephone_number": "321-527-7940",
            "fax_number": "407-670-0428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 WINDERLEY PL STE 226",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327517407",
            "telephone_number": "321-527-7940",
            "fax_number": "407-670-0428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROHEALTH PHARMACY SOLUTIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-12",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A",
        "authorized_official_last_name": "PATRICK",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "412-733-1910"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH29369",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010695000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Community/Retail Pharmacy in Maitland, FL
• Providers in Maitland, FL by specialty
• Community/Retail Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2023; 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.