Medline Enterprises Inc

Primary specialty

PharmacyTaxonomy code 333600000X

License

PH24282 Issued in FL

Legal business name

MEDLINE ENTERPRISES INC

Doing business as

Pasadena Pharmacy

Practice address

1206 Pasadena Ave S
South Pasadena, FL 33707-6202

Phone

(727) 344-5151

Fax

(727) 489-9489

NPI assigned

Oct 26, 2009

Organization subpart

No

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

Authorized official

Name

King Yeotan

Title

President

Phone

(727) 344-5151

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• PASADENA PHARMACY Doing business as

Tax ID family

Medline Enterprises Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Medline Enterprises Inc

  dba promed pharmacy

  • Pharmacy
  • Tampa, FL
  • NPI 1093940496
  NPD tax ID

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

{
    "created_epoch": "1256515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1270512000000",
    "number": "1336475482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 55632",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337325632",
            "telephone_number": "813-494-0458",
            "fax_number": "727-489-9489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1206 PASADENA AVE S",
            "city": "SOUTH PASADENA",
            "state": "FL",
            "postal_code": "337076202",
            "telephone_number": "727-344-5151",
            "fax_number": "727-489-9489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDLINE ENTERPRISES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-26",
        "last_updated": "2010-04-06",
        "status": "A",
        "authorized_official_last_name": "YEOTAN",
        "authorized_official_first_name": "KING",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "727-344-5151"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "FL",
            "license": "PH24282",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "1049926",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PASADENA PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Maturity Medical of Pinellas Professional Association (Maturity Medical of Pinellas, P.A.)
• Shari McCraw, COTA
• Stacy A McDonald, COTA/L
• Timothy Sean McGhee, BCBA
• Carter McKinnon, PTA
• Francine Mihalinec, PTA
• Christy Mikhael, DMD
• Gregory Mines, MD
• William Henry Minnix, M.D.
• Anna Teresa Mixa, PA-C

• Pharmacy in South Pasadena, FL
• Providers in South Pasadena, FL by specialty
• Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2010; 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.