Organization Active NPI

Village Discount Pharmacy

  • Community/Retail Pharmacy
  • Wildwood, FL
National Provider Identifier
1174006399
Registry record updated Sep 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
VILLAGE DISCOUNT PHARMACY
Doing business as
Village Discount Pharmacy LLC
Practice address
3990 E St 44 Suite 207
E SR44 Suite 207
Wildwood, FL 34785
Phone
(407) 492-3041
Fax
(352) 399-6234
NPI assigned
Sep 13, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2024

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

Authorized official

Name
Mr. Gamal Abouelwafa Omar, RPHNPI 1003474453
Title
Owner /Pic
Phone
(352) 492-9333

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
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

3990 E St 44 Suite 207
E SR44 Suite 207
Wildwood, FL 34785

Mailing address

3990 E Sr 44 Ste 207
Wildwood, FL 34785-7482
Phone (352) 492-9333

Other names 2

  • Village Discount Pharmacy LLC Doing business as
  • Village Discount pharmacy Former legal business name

National Provider Directory

National Provider Directory

Locations

3990 E State Road 44
Ste 207
Wildwood, FL 34785
Phone (352) 492-9333

Practitioners & affiliated clinicians

Practitioners 2

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": "1536796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726704000000",
    "number": "1174006399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3990 E SR 44 STE 207",
            "city": "WILDWOOD",
            "state": "FL",
            "postal_code": "347857482",
            "telephone_number": "352-492-9333",
            "fax_number": "352-399-6234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3990 E ST 44 SUITE 207",
            "address_2": "E SR44 SUITE 207",
            "city": "WILDWOOD",
            "state": "FL",
            "postal_code": "34785",
            "telephone_number": "407-492-3041",
            "fax_number": "352-399-6234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE DISCOUNT PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-13",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A",
        "authorized_official_last_name": "OMAR",
        "authorized_official_first_name": "GAMAL",
        "authorized_official_middle_name": "ABOUELWAFA",
        "authorized_official_title_or_position": "OWNER /PIC",
        "authorized_official_telephone_number": "352-492-9333",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Village Discount Pharmacy LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Village Discount pharmacy",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Wildwood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2024; 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.