Prescription Place of Defuniak Springs Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PH21644 Issued in FL

Legal business name

PRESCRIPTION PLACE OF DEFUNIAK SPRINGS INC

Doing business as

The Prescription Place

Practice address

1337 US Highway 90 W
Defuniak Springs, FL 32433-1470

Phone

(850) 892-6898

Fax

(850) 892-6899

NPI assigned

Jul 19, 2006

Last updated

Dec 10, 2015By 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

Shane AbbottNPI 1144336348

Title

Pharmacist

Phone

(850) 892-6898

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• THE PRESCRIPTION PLACE Doing business as

Medicare fee-for-service enrollment

Enrolled in FL2 enrollments

Enrollment records 2

Tax ID family

Prescription Place of Defuniak Springs 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.

• Prescription Place of Defuniak Springs Inc

  • Long Term Care Pharmacy
  • Defuniak Springs, FL
  • NPI 1528925534
  NPD tax ID

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Prescription Place of Niceville LLC

  • Community/Retail Pharmacy
  • Niceville, FL
  • NPI 1891184859

  Member Of

  NPD member

Locations

Practitioners 3

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.

• Shane G Abbott, RPH

  • Pharmacist
  • Defuniak Springs, FL
  • NPI 1144336348
  NPD (past) Authorized official
• Tanner Reece Abbott

  • Pharmacist
  • Defuniak Springs, FL
  • NPI 1497547905
  NPD (past)
• Cari B Cole, PHARMD

  • Pharmacist
  • Defuniak Springs, FL
  • NPI 1548300528
  NPD (past)

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449705600000",
    "number": "1457370520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1337 US HIGHWAY 90 W",
            "city": "DEFUNIAK SPRINGS",
            "state": "FL",
            "postal_code": "324331470",
            "telephone_number": "850-892-6898",
            "fax_number": "850-892-6899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1337 US HIGHWAY 90 W",
            "city": "DEFUNIAK SPRINGS",
            "state": "FL",
            "postal_code": "324331470",
            "telephone_number": "850-892-6898",
            "fax_number": "850-892-6899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESCRIPTION PLACE OF DEFUNIAK SPRINGS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-19",
        "last_updated": "2015-12-10",
        "status": "A",
        "authorized_official_last_name": "ABBOTT",
        "authorized_official_first_name": "SHANE",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "850-892-6898"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH21644",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2005427",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "031129400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "THE PRESCRIPTION PLACE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Angela Renee Pool, ARNP
• Courtney Poore
• Mia Porter, RBT
• Stacy Potts
• Genevieve Powell
• Prescription Place of Defuniak Springs Inc
• Professional Products Inc
• Diane Tellier Quinn, D. C.
• R and S Professional Corporation
• Larry Dean Rafey, PA-C

• Community/Retail Pharmacy in Defuniak Springs, FL
• Providers in Defuniak Springs, 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 Dec 10, 2015; 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.