NPIMap

Organization Active NPI

Midway Specialty Care RX LLC

  • Community/Retail Pharmacy
  • Fort Pierce, FL
National Provider Identifier
1467830638
Registry record updated May 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
MIDWAY SPECIALTY CARE RX LLC
Practice address
3255 S US Highway I
Fort Pierce, FL 34982-6381
Phone
(772) 464-9746
Fax
(772) 464-9750
NPI assigned
May 8, 2015
Organization subpart
Yes
Parent organization
MIDWAY SPECIALTY CARE CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 3, 2022

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

Authorized official

Name
Suzette Wood, PHARMD
Title
Pharmacy Director
Phone
(772) 465-4442

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X PH29049 FL
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

3255 S US Highway I
Fort Pierce, FL 34982-6381

Mailing address

356 E Midway Road
Fort Pierce, FL 34982-7148
Phone (772) 464-9746

Other identifiers 1

IdentifierTypeStateIssuer
5726750OtherNCPDP

Other names 1

  • Midway Specialty Care Center Inc. Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200617000570 FL Part B Supplier - Pharmacy 6608298823 3 other NPIs on this enrollment
Practice locations: Wilton Manors, FL; West Palm Beach, FL; Fort Pierce, FL; Temple Terrace, FL

Other NPIs on the same Medicare enrollment 3

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2202732Midway Specialty Care RX LLC3255 S US Hwy 1, Fort Pierce, FL 34982Certificate of waiverNov 30, 2026

National Provider Directory

National Provider Directory
Tax ID family
Midway Specialty Care RX LLC4 organizations share this tax ID, including this one
Part of
Midway Specialty Care Center Inc

Other organizations with this tax ID 3

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

3255 S US Highway 1
#I
Fort Pierce, FL 34982
Phone (772) 464-9746

Networks

  • 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)
  • 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 Maximo (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)…

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EDJGAD

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1431043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651536000000",
    "number": "1467830638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "356 E MIDWAY ROAD",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349827148",
            "telephone_number": "772-464-9746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3255 S US HIGHWAY I",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349826381",
            "telephone_number": "772-464-9746",
            "fax_number": "772-464-9750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWAY SPECIALTY CARE RX LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MIDWAY SPECIALTY CARE CENTER",
        "enumeration_date": "2015-05-08",
        "last_updated": "2022-05-03",
        "certification_date": "2022-05-03",
        "status": "A",
        "authorized_official_last_name": "WOOD",
        "authorized_official_first_name": "SUZETTE",
        "authorized_official_title_or_position": "PHARMACY DIRECTOR",
        "authorized_official_telephone_number": "772-465-4442",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "FL",
            "license": "PH29049",
            "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": "NCPDP",
            "identifier": "5726750",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Midway Specialty Care Center Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Fort Pierce, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.