Active NPI
Prescription Shoppes LLC
- Pharmacist
- Kissimmee, FL
National Provider Identifier
1124160569
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH19069
- Legal business name
- PRESCRIPTION SHOPPES LLC
- Practice address
- 114 Broadway
Kissimmee, FL 34741-5714 - Phone
- (407) 847-2424
- Fax
- (407) 483-0265
- NPI assigned
- Feb 13, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Samir Amin, PHARMACIST
- Title
- Director
- Phone
- (407) 847-2424
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH19069 | FL | Primary |
Addresses
Primary practice location
114 Broadway
Kissimmee, FL 34741-5714
Mailing address
114 Broadway
Kissimmee, FL 34741-5714
Phone (407) 847-2424
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1006421 | Other | NCPDP | |
| PH19069 | Other | FL | BOARD OF PHARMACY |
| 025924100 | Medicaid | FL |
Other names 1
- The Medicine Shoppe
National Provider Directory
National Provider Directory- Tax ID family
- Prescription Shoppes LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Pharmacist
- Daytona Beach, FL
- NPI 1336281716
Locations
114 Broadway
Kissimmee, FL 34741
Phone (407) 847-2424
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171324800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1678147200000",
"number": "1124160569",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "114 BROADWAY",
"city": "KISSIMMEE",
"state": "FL",
"postal_code": "347415714",
"telephone_number": "407-847-2424",
"fax_number": "407-483-0265"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "114 BROADWAY",
"city": "KISSIMMEE",
"state": "FL",
"postal_code": "347415714",
"telephone_number": "407-847-2424",
"fax_number": "407-483-0265"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PRESCRIPTION SHOPPES LLC",
"organizational_subpart": "NO",
"enumeration_date": "2007-02-13",
"last_updated": "2023-03-07",
"status": "A",
"authorized_official_last_name": "AMIN",
"authorized_official_first_name": "SAMIR",
"authorized_official_title_or_position": "DIRECTOR",
"authorized_official_telephone_number": "407-847-2424",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "PHARMACIST"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Pharmacist",
"state": "FL",
"license": "PH19069",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPDP",
"identifier": "1006421",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD OF PHARMACY",
"identifier": "PH19069",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "025924100",
"state": "FL"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "The Medicine Shoppe",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Kissimmee, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.