Individual provider Active NPI

Hallie Renee Zagrocki, PHARMD

  • Community/Retail Pharmacy
  • Bradenton, FL
National Provider Identifier
1255054433
Registry record updated Sep 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PS64877 Issued in FL
Practice address
7290 55TH Ave E
Bradenton, FL 34203-8002
Phone
(941) 727-8412
Fax
(941) 727-8195
NPI assigned
Sep 22, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PS64877 FL Primary

Addresses

Primary practice location

7290 55TH Ave E
Bradenton, FL 34203-8002

Mailing address

718 Old Quarry Rd
Bradenton, FL 34212-2620
Phone (904) 803-9321

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PS64877FLMDCommunity/Retail Pharmacy

NPI Registry JSON

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

{
    "created_epoch": "1663804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663804800000",
    "number": "1255054433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "718 OLD QUARRY RD",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342122620",
            "telephone_number": "904-803-9321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7290 55TH AVE E",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342038002",
            "telephone_number": "941-727-8412",
            "fax_number": "941-727-8195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAGROCKI",
        "first_name": "HALLIE",
        "middle_name": "RENEE",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-22",
        "last_updated": "2022-09-22",
        "certification_date": "2022-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PS64877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2022; 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.