David Anthony Derby

Primary specialty

PharmacistTaxonomy code 183500000X

License

PS30659 Issued in FL

Practice address

6817 Taft St
Hollywood, FL 33024-5601

Phone

(954) 989-8900

Fax

(954) 989-6406

NPI assigned

Oct 13, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Walgreen Co

  • Pharmacy
  • Hollywood, FL
  • NPI 1235144585
  NPD (past)
• Walgreen Co

  • Pharmacy
  • Longview, TX
  • NPI 1629956545
  NPD (past)

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

{
    "created_epoch": "1318464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318464000000",
    "number": "1457636102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6817 TAFT ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330245601",
            "telephone_number": "954-989-8900",
            "fax_number": "954-989-6406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6817 TAFT ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330245601",
            "telephone_number": "954-989-8900",
            "fax_number": "954-989-6406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERBY",
        "first_name": "DAVID",
        "middle_name": "ANTHONY",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-10-13",
        "last_updated": "2011-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS30659",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102025100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dentists of Hollywood, PA
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• Amy Christian Deramo, AGACNP-BC
• Shantrell Britany Derazin
• Cindy Sayonara Derequito, APRN
• Deborah Dergan, M.D.
• Dermatology Group of Florida PA
• Dermatology Group of Florida PA
• Dermatology Group of Florida PA

• Pharmacist in Hollywood, FL
• Providers in Hollywood, FL by specialty
• Pharmacist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2011; 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.