Active NPI
Randall Walters O'Neill Jr., RPH
- Pharmacist
- Melbourne Beach, FL
National Provider Identifier
1114264058
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS28818
- Practice address
- 3830 S Hwy A1A
Melbourne Beach, FL 32951-3143 - Phone
- (321) 725-3711
- Fax
- (321) 725-4435
- NPI assigned
- Jan 11, 2013
- Last updated
- Jan 11, 2013
- Sex
- Male
- 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 | PS28818 | FL | Primary |
Addresses
Primary practice location
3830 S Hwy A1A
Melbourne Beach, FL 32951-3143
Mailing address
3830 S Hwy A1A
Melbourne Beach, FL 32951-3143
Phone (321) 725-3711
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 |
|---|---|---|---|
| PS28818 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sebastian Pharmacy LLC | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Sebastian Discount Pharmacy
- Community/Retail Pharmacy
- Winter Garden, FL
- NPI 1730612243
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1357862400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1357862400000",
"number": "1114264058",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3830 S HWY A1A",
"city": "MELBOURNE BEACH",
"state": "FL",
"postal_code": "329513143",
"telephone_number": "321-725-3711",
"fax_number": "321-725-4435"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3830 S HWY A1A",
"city": "MELBOURNE BEACH",
"state": "FL",
"postal_code": "329513143",
"telephone_number": "321-725-3711",
"fax_number": "321-725-4435"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'NEILL",
"first_name": "RANDALL",
"middle_name": "WALTERS",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-01-11",
"last_updated": "2013-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS28818",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Melbourne Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.