NPIMap

Organization Active NPI

St.Cloud Pharmacy&Wellness Center

  • Community/Retail Pharmacy
  • Saint Cloud, FL
National Provider Identifier
1205328663
Registry record updated Jun 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PH31091 Issued in FL
Legal business name
ST.CLOUD PHARMACY&WELLNESS CENTER
Practice address
2801 13TH St
Saint Cloud, FL 34769-4134
Phone
(407) 593-2959
NPI assigned
Jun 1, 2018
Organization subpart
Yes
Parent organization
ST.CLOUD PHARMACY & WELLNESS CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 1, 2018

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

Authorized official

Name
Saji Thomas
Title
Employee
Phone
(407) 593-2959

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PH31091 FL Primary

Addresses

Primary practice location

2801 13TH St
Saint Cloud, FL 34769-4134

Mailing address

2801 13TH St
Saint Cloud, FL 34769-4134
Phone (407) 593-2959

Other identifiers 1

IdentifierTypeStateIssuer
3565000MedicaidFL

Other names 1

  • ST.CLOUD COMPOUNDING PHARMACY AND WELLNESS CENTER Other name

National Provider Directory

National Provider Directory
Tax ID family
Saint Cloud Pharmacy4 organizations share this tax ID, including this one
Part of
Saint Cloud Pharmacy

Other organizations with this tax ID 3

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

Locations

2801 13th St
Saint Cloud, FL 34769
Phone (407) 593-2958

NPI Registry JSON

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

{
    "created_epoch": "1527811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527811200000",
    "number": "1205328663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 13TH ST",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347694134",
            "telephone_number": "407-593-2959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 13TH ST",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347694134",
            "telephone_number": "407-593-2959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST.CLOUD PHARMACY&WELLNESS CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST.CLOUD PHARMACY & WELLNESS CENTER",
        "enumeration_date": "2018-06-01",
        "last_updated": "2018-06-01",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "SAJI",
        "authorized_official_title_or_position": "EMPLOYEE",
        "authorized_official_telephone_number": "407-593-2959"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH31091",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3565000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ST.CLOUD COMPOUNDING PHARMACY AND WELLNESS CENTER",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Saint Cloud, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2018; 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.