NPIMap

Organization Active NPI

Merritt Island Pharmacy

  • Long Term Care Pharmacy
  • Merritt Island, FL
National Provider Identifier
1124766159
Registry record updated May 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
MERRITT ISLAND PHARMACY
Practice address
35 N Courtenay Pkwy
Merritt Island, FL 32953-3476
Phone
(321) 454-0911
Fax
(321) 459-2479
NPI assigned
May 20, 2022
Organization subpart
Yes
Parent organization
MERRITT ISLAND PHARMACYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 20, 2022

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

Authorized official

Name
Bhavin Ratilal DhadukNPI 1659646842
Title
Pharmacy Manager
Phone
(321) 454-0911

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X Primary

Addresses

Primary practice location

35 N Courtenay Pkwy
Merritt Island, FL 32953-3476

Mailing address

35 N Courtenay Pkwy
Merritt Island, FL 32953-3476
Phone (321) 454-0911

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL merrittislandpharmacy@gmail.com

National Provider Directory

National Provider Directory
Tax ID family
Merritt Island Pharmacy2 organizations share this tax ID, including this one
Part of
Merritt Island Pharmacy

Other organizations with this tax ID 1

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

Locations

35 N Courtenay Pkwy
Merritt Island, FL 32953
Phone (321) 454-0911

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)…

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.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1653004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653004800000",
    "number": "1124766159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 N COURTENAY PKWY",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329533476",
            "telephone_number": "321-454-0911",
            "fax_number": "321-459-2479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 N COURTENAY PKWY",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329533476",
            "telephone_number": "321-454-0911",
            "fax_number": "321-459-2479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERRITT ISLAND PHARMACY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MERRITT ISLAND PHARMACY",
        "enumeration_date": "2022-05-20",
        "last_updated": "2022-05-20",
        "certification_date": "2022-05-05",
        "status": "A",
        "authorized_official_last_name": "DHADUK",
        "authorized_official_first_name": "BHAVIN",
        "authorized_official_middle_name": "RATILAL",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "321-454-0911"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "merrittislandpharmacy@gmail.com",
            "affiliation": "N",
            "endpointDescription": "Email Address",
            "address_1": "35 N Courtenay Pkwy",
            "city": "Merritt Island",
            "state": "FL",
            "country_code": "US",
            "postal_code": "329533476",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Merritt Island, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2022; 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.