Service Pro Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

30372 Issued in FL

Legal business name

SERVICE PRO PHARMACY LLC

Practice address

4880 Woodbine Rd
Pace, FL 32571-8762

Phone

(850) 995-9999

Fax

(850) 995-0095

NPI assigned

Nov 7, 2016

Organization subpart

No

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

Authorized official

Name

Stuart Viator

Title

President

Phone

(850) 516-5886

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Service Pro Pharmacy Doing business as

Tax ID family

Service Pro Pharmacy2 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.

• Service Pro Pharmacy LLC

  • Community/Retail Pharmacy
  • Milton, FL
  • NPI 1700233368
  NPD tax ID

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

{
    "created_epoch": "1478476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478476800000",
    "number": "1477095685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4880 WOODBINE RD",
            "city": "PACE",
            "state": "FL",
            "postal_code": "325718762",
            "telephone_number": "850-995-9999",
            "fax_number": "850-995-0095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4880 WOODBINE RD",
            "city": "PACE",
            "state": "FL",
            "postal_code": "325718762",
            "telephone_number": "850-995-9999",
            "fax_number": "850-995-0095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERVICE PRO PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-07",
        "last_updated": "2016-11-07",
        "status": "A",
        "authorized_official_last_name": "VIATOR",
        "authorized_official_first_name": "STUART",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "850-516-5886"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "30372",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2165886",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Service Pro Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Reghan Jane Schutzmann, OTR/L
• Jeffrey Adam Scott, PHARMD
• James Maddern Sellers IV
• Judith Lauren Selover
• Serenity Springs Counseling, LLC
• Adriana Jae Shaarda, OTR/L
• Theresa Gayle Sheahan, CRNA
• Jeannie Villanueva Shields
• Carlee Smith, PT, DPT
• Katrina Marie Smith, LPC

• Community/Retail Pharmacy in Pace, FL
• Providers in Pace, 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 Nov 7, 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.