NPIMap

Organization Active NPI

Midway Specialty Care RX LLC

  • Community/Retail Pharmacy
  • Wilton Manors, FL
National Provider Identifier
1114516523
Registry record updated Jan 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
MIDWAY SPECIALTY CARE RX LLC
Practice address
2608 NE 16TH Ave
Wilton Manors, FL 33334-4319
Phone
(954) 932-0691
Fax
(954) 932-0692
NPI assigned
Jan 12, 2021
Organization subpart
Yes
Parent organization
MIDWAY SPECIALTY CARE CENTER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 12, 2021

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

Authorized official

Name
Suzette Wood, PHARMD
Title
Director of Pharmacy
Phone
(954) 892-1877

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

2608 NE 16TH Ave
Wilton Manors, FL 33334-4319

Mailing address

3255 S US Highway
Building # 2, Suite 1
Fort Pierce, FL 34982
Phone (954) 932-0691

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200617000570 FL Part B Supplier - Pharmacy 6608298823 3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wilton Manors, FL; West Palm Beach, FL; Fort Pierce, FL; Temple Terrace, FL

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Midway Specialty Care RX LLC4 organizations share this tax ID, including this one
Part of
Midway Specialty Care Center Inc

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Networks

  • 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)
  • 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)…
  • HealthSun Health Plans Network

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1610409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610409600000",
    "number": "1114516523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3255 S US HIGHWAY",
            "address_2": "BUILDING # 2, SUITE 1",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "34982",
            "telephone_number": "954-932-0691",
            "fax_number": "954-932-0692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2608 NE 16TH AVE",
            "city": "WILTON MANORS",
            "state": "FL",
            "postal_code": "333344319",
            "telephone_number": "954-932-0691",
            "fax_number": "954-932-0692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWAY SPECIALTY CARE RX LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MIDWAY SPECIALTY CARE CENTER INC",
        "enumeration_date": "2021-01-12",
        "last_updated": "2021-01-12",
        "certification_date": "2020-12-22",
        "status": "A",
        "authorized_official_last_name": "WOOD",
        "authorized_official_first_name": "SUZETTE",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "954-892-1877",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilton Manors, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.