NPIMap

Organization Active NPI

Centerwell Pharmacy, Inc.

Doing business as Humana Pharmacy, Inc.

  • Community/Retail Pharmacy
  • Jacksonville, FL
National Provider Identifier
1407226392
Registry record updated Feb 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PH29426 Issued in FL
Legal business name
CENTERWELL PHARMACY, INC.
Doing business as
Humana Pharmacy, Inc.
Practice address
11240 Beach Blvd
Jacksonville, FL 32246-3802
Phone
(904) 380-0318
NPI assigned
Oct 5, 2015
Last updated
Feb 24, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2026

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

Authorized official

Name
Sean Lysinger
Title
VP
Phone
(502) 580-2376

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PH29426 FL Primary

Addresses

Primary practice location

11240 Beach Blvd
Jacksonville, FL 32246-3802

Mailing address

11240 Beach Blvd
Jacksonville, FL 32246-3802
Phone (904) 380-0320

Other identifiers 1

IdentifierTypeStateIssuer
2154401OtherPK

Other names 1

  • Humana Pharmacy, Inc. Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20191008000279 FL Part B Supplier - Pharmacy 9739233743 28 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: West Palm Beach, FL; Port Orange, FL; Plantation, FL; Plant City, FL; Pembroke Pines, FL; Ormond Beach, FL; Orange City, FL; North Miami Beach, FL…
O20191015000355 FL Part B Supplier - Pharmacy 9739233743 1 other NPI on this enrollment
Practice locations: Jacksonville, FL; Tampa, FL

Other NPIs with the same Medicare PAC ID 20

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 20

Other NPIs on the same Medicare enrollment 22

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 22

National Provider Directory

National Provider Directory
Tax ID family
Centerwell Pharmacy Inc47 organizations share this tax ID, including this one

Other organizations with this tax ID 46

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

View all 46

NPI Registry JSON

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

{
    "created_epoch": "1444003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771891200000",
    "number": "1407226392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11240 BEACH BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322463802",
            "telephone_number": "904-380-0320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11240 BEACH BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322463802",
            "telephone_number": "904-380-0318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTERWELL PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-05",
        "last_updated": "2026-02-24",
        "certification_date": "2026-02-24",
        "status": "A",
        "authorized_official_last_name": "LYSINGER",
        "authorized_official_first_name": "SEAN",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "502-580-2376"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH29426",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2154401",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Humana Pharmacy, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.