Villa Pharmacy LLC

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

PH2986 Issued in FL

Legal business name

VILLA PHARMACY LLC

Practice address

105 Avenue R NW
Winter Haven, FL 33881-2147

Phone

(863) 229-5978

Fax

(863) 662-3953

NPI assigned

Feb 17, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Dwayne Jones

Title

Pharmacy Manager

Phone

(863) 229-5978

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Villa Medical Health Solutions Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kevin Pruitt V, PH.D

  • Pharmacist
  • Winter Haven, FL
  • NPI 1336554005
  NPD (past)

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

{
    "created_epoch": "1455667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467676800000",
    "number": "1215396346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 AVENUE R NW",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338812147",
            "telephone_number": "863-229-5978",
            "fax_number": "863-662-3953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 AVENUE R NW",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338812147",
            "telephone_number": "863-229-5978",
            "fax_number": "863-662-3953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLA PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-17",
        "last_updated": "2016-07-05",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "DWAYNE",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "863-229-5978",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "FL",
            "license": "PH2986",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2158247",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Villa Medical Health Solutions",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Raymond Thomas Vervoort
• Lee Tramell Vickers
• Aleixo M Viegas, MD
• Viet Ho Inc
• Jose R Vigoreaux, M.D.
• Villa Pharmacy LLC
• Jorge Ramon Villarreal, M.D.
• Ryan Alexander Villarreal, MD
• Visana Home Care Services, LLC
• Vitreous & Retina Consultants, PA

• Long Term Care Pharmacy in Winter Haven, FL
• Providers in Winter Haven, FL by specialty
• Long Term Care Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 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.