Havana LTC Pharmacy Inc

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

PH21424 Issued in FL

Legal business name

HAVANA LTC PHARMACY INC

Doing business as

Havana LTC Pharmacy Inc

Practice address

3818 S Himes Ave Ste 1
Tampa, FL 33611-1413

Phone

(813) 875-5914

Fax

(813) 875-5924

NPI assigned

Feb 3, 2006

Last updated

Dec 13, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Yamilet CruzNPI 1457756165

Title

Owner

Phone

(813) 875-5914

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• HAVANA LTC PHARMACY INC Doing business as

Locations

Networks

• Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Máximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
• Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Yamilet Cruz

  • Pharmacy Technician
  • Tampa, FL
  • NPI 1457756165
  NPD (past) Authorized official

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

{
    "created_epoch": "1138924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481587200000",
    "number": "1437121365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3818 S HIMES AVE",
            "address_2": "SUITE #1",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336111413",
            "telephone_number": "813-875-5914",
            "fax_number": "813-875-5924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3818 S HIMES AVE STE 1",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336111413",
            "telephone_number": "813-875-5914",
            "fax_number": "813-875-5924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVANA LTC PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-03",
        "last_updated": "2016-12-13",
        "status": "A",
        "authorized_official_last_name": "CRUZ",
        "authorized_official_first_name": "YAMILET",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-875-5914"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "FL",
            "license": "PH21424",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2005033",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "030971100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HAVANA LTC PHARMACY INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Eric Haura, MD
• Joann Hauser, ATC
• Robert Hauser, MD
• Robin C Hauser, M.D.
• Stacy Hausinger, ARNP
• Victoria Havard
• Katherine Havemann
• Haven Alf, Inc.
• Haven Counseling Collective LLC
• Haven HHC 6 LLC

• Long Term Care Pharmacy in Tampa, FL
• Providers in Tampa, FL by specialty
• Long Term Care Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2016; 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.