Rock 3

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PH24391 Issued in FL

Legal business name

ROCK 3

Practice address

2448 US Highway 1
Mims, FL 32754-3854

Phone

(321) 567-4919

NPI assigned

Jan 12, 2010

Organization subpart

No

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

Authorized official

Name

John Oni

Title

Pharmacy Manager

Phone

(850) 292-1917

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Mims Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1263254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461283200000",
    "number": "1194055244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 410917",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329410917",
            "telephone_number": "850-292-1917",
            "fax_number": "321-259-3330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2448 US HIGHWAY 1",
            "city": "MIMS",
            "state": "FL",
            "postal_code": "327543854",
            "telephone_number": "321-567-4919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCK 3",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-12",
        "last_updated": "2016-04-22",
        "status": "A",
        "authorized_official_last_name": "ONI",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "850-292-1917"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH24391",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2123396",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002203800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mims Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tyler Melton
• Lillian Theresa Merideth, CNA
• Lowanda B Mullican
• James Thomas Nichols III, MD
• April Rife, PHARMD
• Yarinell NMN Roman, HHP, MR, MH
• Nanette Rupke, FNP-C
• Amy L Sadler
• Carlene Natasha Sapp Kent, LPN
• Morgan Shropshire, PHARMD

• Community/Retail Pharmacy in Mims, FL
• Providers in Mims, FL by specialty
• Community/Retail Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2016; 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.