Medlife Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PH29430 Issued in FL

Legal business name

MEDLIFE PHARMACY LLC

Practice address

736 S Dillard St Unit C
Winter Garden, FL 34787-3908

Phone

(407) 656-2604

Fax

(407) 654-1464

NPI assigned

Mar 10, 2014

Organization subpart

No

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

Authorized official

Name

Vamsee Charan Nalagandla

Title

Pharmacy Manager

Phone

(407) 656-2604

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• wintergarden pharmacy Doing business as

Locations

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 Maximo (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)

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

{
    "created_epoch": "1394409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626652800000",
    "number": "1114343597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "736 S DILLARD ST UNIT C",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347873908",
            "telephone_number": "407-656-2604",
            "fax_number": "407-654-1464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "736 S DILLARD ST UNIT C",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347873908",
            "telephone_number": "407-656-2604",
            "fax_number": "407-654-1464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDLIFE PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-10",
        "last_updated": "2021-07-19",
        "certification_date": "2021-07-19",
        "status": "A",
        "authorized_official_last_name": "NALAGANDLA",
        "authorized_official_first_name": "VAMSEE",
        "authorized_official_middle_name": "CHARAN",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "407-656-2604"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH29430",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "014189300",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2154708",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "wintergarden pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "wintergarden pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Erika Barbara Mederos Betancourt
• Medhealth Clinical Inc.
• Medical Home Alliance LLC
• Tailyn Medina Suarez, DMD
• Moraima Medina, MS
• Medlife Pharmacy LLC
• Mehmood Nawab Inc
• Melann Trans LLC
• Angeliz Marie Melendez
• Ricky Melendy, PTA

• Community/Retail Pharmacy in Winter Garden, FL
• Providers in Winter Garden, 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 Jul 19, 2021; 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.