St. Verena LLC.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PH27506 Issued in FL

Legal business name

ST. VERENA LLC.

Practice address

13910 Fivay Rd
Suite 3
Hudson, FL 34667-7154

Phone

(813) 920-7063

NPI assigned

Apr 7, 2014

Organization subpart

No

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

Authorized official

Name

Baher RizkallaNPI 1710518063

Title

Pharmacist/Owner

Phone

(813) 464-0563

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Medsource Pharmacy Doing business as

Locations

Practitioners 1

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

• Baher Rizkalla

  • Pharmacist
  • New Port Richey, FL
  • NPI 1710518063
  NPD (past) Authorized official

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

{
    "created_epoch": "1396828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396828800000",
    "number": "1245658236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3633 BENERAID ST",
            "city": "LAND O LAKES",
            "state": "FL",
            "postal_code": "346387919",
            "telephone_number": "813-464-0563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13910 FIVAY RD",
            "address_2": "SUITE 3",
            "city": "HUDSON",
            "state": "FL",
            "postal_code": "346677154",
            "telephone_number": "813-920-7063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. VERENA LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-07",
        "last_updated": "2014-04-07",
        "status": "A",
        "authorized_official_last_name": "RIZKALLA",
        "authorized_official_first_name": "BAHER",
        "authorized_official_title_or_position": "PHARMACIST/OWNER",
        "authorized_official_telephone_number": "813-464-0563"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH27506",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2145050",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medsource Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Olive Spoeth
• Stacy Sprehe, PA
• Sprout Together LLC
• SPT Consulting, PLLC
• SS Pasco Community HC LLC
• Stadion Inpatient Services LLC
• Michael Stagg, DO
• Starlight Assisted Living at Hudson
• Stateserv Medical of Florida, LLC
• Adam Joseph Stebbins, CRNA

• Community/Retail Pharmacy in Hudson, FL
• Providers in Hudson, 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 7, 2014; 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.