NPIMap

Organization Active NPI

St. Mary and St. Anthony LLC

  • Community/Retail Pharmacy
  • Vero Beach, FL
National Provider Identifier
1174280911
Registry record updated Nov 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
ST. MARY AND ST. ANTHONY LLC
Practice address
595 21St St Unit 100
Vero Beach, FL 32960-5449
Phone
(772) 713-9303
Fax
(772) 448-4064
NPI assigned
Nov 28, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2021

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

Authorized official

Name
Michael Marzouk
Title
Owner/MGR
Phone
(772) 713-9303

Specialties & licenses 1

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

Addresses

Primary practice location

595 21St St Unit 100
Vero Beach, FL 32960-5449

Mailing address

2190 3Rd LN SW
Vero Beach, FL 32962-3372
Phone (772) 713-9303

Other names 1

  • Royal Care Pharmacy 3 Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220630001006 FL Part B Supplier - Pharmacy 3072911791 Practice locations: Vero Beach, FL

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Royal Care Pharmacy3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

5045 Turnpike Feeder Rd
Fort Pierce, FL 34951
Phone (772) 713-9303

378 SE Port St Lucie Blvd
Port St Lucie, FL 34984
Phone (772) 713-1244

595 21st St
Ste 100
Vero Beach, FL 32960
Phone (772) 365-4462

Networks

  • 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)…
  • 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)

NPI Registry JSON

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

{
    "created_epoch": "1638057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638057600000",
    "number": "1174280911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2190 3RD LN SW",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329623372",
            "telephone_number": "772-713-9303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "595 21ST ST UNIT 100",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329605449",
            "telephone_number": "772-713-9303",
            "fax_number": "772-448-4064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. MARY AND ST. ANTHONY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-28",
        "last_updated": "2021-11-28",
        "certification_date": "2021-11-28",
        "status": "A",
        "authorized_official_last_name": "MARZOUK",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER/MGR",
        "authorized_official_telephone_number": "772-713-9303"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Royal Care Pharmacy 3",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vero Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 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.