NPIMap

Organization Active NPI

Goncan Inc

  • Community/Retail Pharmacy
  • Fort Pierce, FL
National Provider Identifier
1326358516
Registry record updated Feb 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PH24941 Issued in FL
Legal business name
GONCAN INC
Doing business as
TRINITY PHARMACY
Practice address
800 Virginia Ave
Suite #33
Fort Pierce, FL 34982-5829
Phone
(772) 882-4785
Fax
(772) 519-9982
NPI assigned
Oct 21, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2013

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

Authorized official

Name
Godwin Nwaobi
Title
Prescription Dept.Manager
Phone
(772) 882-4785

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PH24941 FL Primary

Addresses

Primary practice location

800 Virginia Ave
Suite #33
Fort Pierce, FL 34982-5829

Mailing address

800 Virginia Ave
Suite #33
Fort Pierce, FL 34982-5829
Phone (772) 882-4785

Other identifiers 2

IdentifierTypeStateIssuer
003799300MedicaidFL
5702231OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • TRINITY PHARMACY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Goncan Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

800 Virginia Ave
Ste 33
Fort Pierce, FL 34982
Phone (772) 882-4785

NPI Registry JSON

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

{
    "created_epoch": "1287619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359676800000",
    "number": "1326358516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 VIRGINIA AVE",
            "address_2": "SUITE #33",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349825829",
            "telephone_number": "772-882-4785",
            "fax_number": "772-519-9982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 VIRGINIA AVE",
            "address_2": "SUITE #33",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349825829",
            "telephone_number": "772-882-4785",
            "fax_number": "772-519-9982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GONCAN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-21",
        "last_updated": "2013-02-01",
        "status": "A",
        "authorized_official_last_name": "NWAOBI",
        "authorized_official_first_name": "GODWIN",
        "authorized_official_title_or_position": "PRESCRIPTION DEPT.MANAGER",
        "authorized_official_telephone_number": "772-882-4785"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH24941",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003799300",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "5702231",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TRINITY PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Pierce, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2013; 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.