NPIMap

Organization Active NPI

Medical Home Alliance LLC

Doing business as IMA Downtown Kissimmee Dispensary

  • Non-Pharmacy Dispensing Site
  • Kissimmee, FL
National Provider Identifier
1285163477
Registry record updated Jun 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
Legal business name
MEDICAL HOME ALLIANCE LLC
Doing business as
IMA Downtown Kissimmee Dispensary
Practice address
431 W Oak St
Kissimmee, FL 34741-6627
Phone
(407) 845-0330
Fax
(888) 972-1752
NPI assigned
Jun 9, 2017
Last updated
Jun 29, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
INHEALTH MD ALLIANCEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 29, 2017

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

Authorized official

Name
Mrs. Patricia Pichardo
Title
Coo
Phone
(407) 845-0330

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X NU Primary

Addresses

Primary practice location

431 W Oak St
Kissimmee, FL 34741-6627

Mailing address

6675 Westwood Blvd Ste 475
Orlando, FL 32821-6027
Phone (407) 845-0330

Other names 1

  • IMA Downtown Kissimmee Dispensary Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Medical Home Alliance LLC37 organizations share this tax ID, including this one
Part of
Medical Home Alliance LLC

Other organizations with this tax ID 36

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

View all 36

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1496966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1498694400000",
    "number": "1285163477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6675 WESTWOOD BLVD STE 475",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328216027",
            "telephone_number": "407-845-0330",
            "fax_number": "888-972-1752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "431 W OAK ST",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347416627",
            "telephone_number": "407-845-0330",
            "fax_number": "888-972-1752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL HOME ALLIANCE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INHEALTH MD ALLIANCE",
        "enumeration_date": "2017-06-09",
        "last_updated": "2017-06-29",
        "status": "A",
        "authorized_official_last_name": "PICHARDO",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "407-845-0330",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IMA Downtown Kissimmee Dispensary",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2017; 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.