Polk City Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

POLK CITY PHARMACY INC

Practice address

108 N Commonwealth Ave
Polk City, FL 33868-9506

Phone

(863) 984-3427

Fax

(863) 984-9631

NPI assigned

Oct 2, 2006

Organization subpart

No

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

Authorized official

Name

Jacqueline A Futch, PHARMDNPI 1710089669

Title

Owner Pharmacist

Phone

(863) 984-9631

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• MEDICINE SHOPPE Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jacqueline Anne Futch, PHARMD

  • Pharmacist
  • Polk City, FL
  • NPI 1710089669
  NPD (past) Authorized official

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1417040486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 N COMMONWEALTH AVE",
            "city": "POLK CITY",
            "state": "FL",
            "postal_code": "338689506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 N COMMONWEALTH AVE",
            "city": "POLK CITY",
            "state": "FL",
            "postal_code": "338689506",
            "telephone_number": "863-984-3427",
            "fax_number": "863-984-9631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POLK CITY PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "FUTCH",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER PHARMACIST",
        "authorized_official_telephone_number": "863-984-9631",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "FL",
            "license": "PH21515",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "1053987",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEDICINE SHOPPE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sharon Lee Kain, PTA
• Kreative Dental Care PA
• Kristen Smith
• Edgar Morales
• Maria Auxiliadora Painter, DNP, AGNP-BC
• Polk Correctional Institution
• Quality Care HHS
• Paula Cleopatra Quintero
• Diego Ramirez, ATC, LAT, LMT.
• Rapid Speech Therapy LLC

• Community/Retail Pharmacy in Polk City, FL
• Providers in Polk City, FL by specialty
• Community/Retail Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.