NPIMap

Organization Active NPI

Promise Pharmacy LLC

  • Community/Retail Pharmacy
  • Palm Harbor, FL
National Provider Identifier
1124132196
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PH22007 Issued in FL
Legal business name
PROMISE PHARMACY LLC
Practice address
31818 US 19 N
Palm Harbor, FL 34684-3713
Phone
(727) 772-0500
Fax
(727) 772-0511
NPI assigned
Aug 18, 2006
Last updated
Mar 17, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Authorized official

Name
Mrs. Dipti PatelNPI 1821856550
Title
Owner
Phone
(727) 772-0500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Community/Retail Pharmacy 3336C0003X PH22007 FL Primary
Compounding Pharmacy 3336C0004X NU

Addresses

Primary practice location

31818 US 19 N
Palm Harbor, FL 34684-3713

Mailing address

31818 US 19 S
Palm Harbor, FL 34684
Phone (727) 772-0500

Other practice location 1

31818 US 19 S
Palm Harbor, FL 34684
Phone (727) 772-0500

Other identifiers 2

IdentifierTypeStateIssuer
031568100MedicaidFL
2006789OtherPK

National Provider Directory

National Provider Directory

Locations

31818 US Highway 19 N
Palm Harbor, FL 34684
Phone (727) 772-0500

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1124132196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31818 US 19 S",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "34684",
            "telephone_number": "727-772-0500",
            "fax_number": "727-772-0511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31818 US 19 N",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346843713",
            "telephone_number": "727-772-0500",
            "fax_number": "727-772-0511"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "31818 US 19 S",
            "address_purpose": "LOCATION",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "34684",
            "country_code": "US",
            "telephone_number": "727-772-0500",
            "fax_number": "727-772-0511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PROMISE PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-18",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "DIPTI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "727-772-0500",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH22007",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "031568100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2006789",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Harbor, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.