Med 1St LLC

Primary specialty

Managed Care Organization PharmacyTaxonomy code 3336M0003X

License

PH22474 Issued in FL

Legal business name

MED 1ST LLC

Doing business as

Med 1St

Practice address

11206 Challenger Ave
Unit D
Odessa, FL 33556-3482

Phone

(727) 375-9898

Fax

(727) 375-9870

NPI assigned

Apr 6, 2007

Organization subpart

No

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

Authorized official

Name

Terence Williams

Title

Co Owner

Phone

(727) 375-9898

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• MED 1ST Doing business as

Locations

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251676800000",
    "number": "1174645477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11206 CHALLENGER AVE",
            "address_2": "UNIT D",
            "city": "ODESSA",
            "state": "FL",
            "postal_code": "335563482",
            "telephone_number": "727-375-9898",
            "fax_number": "727-375-9870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11206 CHALLENGER AVE",
            "address_2": "UNIT D",
            "city": "ODESSA",
            "state": "FL",
            "postal_code": "335563482",
            "telephone_number": "727-375-9898",
            "fax_number": "727-375-9870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MED 1ST LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-06",
        "last_updated": "2009-08-31",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "TERENCE",
        "authorized_official_title_or_position": "CO OWNER",
        "authorized_official_telephone_number": "727-375-9898"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336M0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Managed Care Organization Pharmacy",
            "state": "FL",
            "license": "PH22474",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "1025370",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MED 1ST",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pharmacy in Odessa, FL
• Providers in Odessa, FL by specialty
• Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2009; 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.