Main Street Pharmacy of Safety Harbor LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

MAIN STREET PHARMACY OF SAFETY HARBOR LLC

Practice address

531 Main St
Suite K
Safety Harbor, FL 34695-3558

Phone

(727) 787-6072

Fax

(727) 787-6072

NPI assigned

Aug 17, 2014

Organization subpart

No

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

Authorized official

Name

Phyllis RaderNPI 1588287619

Title

Owner/Pharmacist

Phone

(727) 330-7530

Specialties & licenses 1

Addresses

Other names 1

• Main Street Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

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

CLIA laboratory certificates

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)…

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Phyllis Rader, RPH

  • Pharmacist
  • Safety Harbor, FL
  • NPI 1588287619
  NPD Authorized official
• Cynthia Jergins, PHARMD.

  • Pharmacist
  • Tampa, FL
  • NPI 1245442698
  NPD (past)
• Louis Henry Mueller, R.PH.

  • Pharmacist
  • Safety Harbor, FL
  • NPI 1114131059
  NPD (past)

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

{
    "created_epoch": "1408233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737504000000",
    "number": "1487053344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "531 MAIN ST",
            "address_2": "SUITE K",
            "city": "SAFETY HARBOR",
            "state": "FL",
            "postal_code": "346953558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "531 MAIN ST",
            "address_2": "SUITE K",
            "city": "SAFETY HARBOR",
            "state": "FL",
            "postal_code": "346953558",
            "telephone_number": "727-787-6072",
            "fax_number": "727-787-6072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN STREET PHARMACY OF SAFETY HARBOR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-17",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A",
        "authorized_official_last_name": "RADER",
        "authorized_official_first_name": "PHYLLIS",
        "authorized_official_title_or_position": "OWNER/PHARMACIST",
        "authorized_official_telephone_number": "727-330-7530"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "0",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Main Street Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Main Street Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Josephine A. Lucas, D.P.M.
• Lucky Medical Associates LLC
• Yannira Lugo, M.D.
• Margaret Lukez, ARNP
• Deborah Lynford, FNP-C
• Stephen John Malachowski, MD
• Kalyanchakravarthi Mallela, M.D.
• Peggy Mallis, CRNA
• Joshua B Mandel, M.D.
• Natalie Nga Mang, D.O.

• Community/Retail Pharmacy in Safety Harbor, FL
• Providers in Safety Harbor, 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 Jan 22, 2025; 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.