Patricia Chenenko, PHARMACIST
Individual provider Active NPI Pharmacist · Belle Glade, FL
NPI 1245805084 · NPPES record last updated May 24, 2021
Key facts
- NPI
- 1245805084
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- PS61858 (FL)
- Practice address
- 101 S Main St
Belle Glade, FL 33430-3423 - Phone
- (561) 996-7707
- NPI assigned
- May 24, 2021
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS61858 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Holiday CVS L.L.C. | Past |
Accepting new patients | |
| Holiday CVS LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS61858 | FL | Yes |
Addresses
Primary practice location
101 S Main St
Belle Glade, FL 33430-3423
Mailing address
101 S Main St
Belle Glade, FL 33430-3423
Phone (561) 996-7707
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 28RI02067100 | Other | NJ | PHARMACIST LICENSE |
| PS61858 | Other | FL | PHARMACIST LICENSE |
Other providers in Belle Glade, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 24, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.