Legacy Pharmacy Oc LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

LEGACY PHARMACY OC LLC

Practice address

921 Town Center Dr Ste 100
Orange City, FL 32763-8266

Phone

(386) 218-4993

Fax

(386) 218-4913

NPI assigned

Apr 19, 2013

Organization subpart

No

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

Authorized official

Name

Mrs. Dipti A Smart, PHARM.D

Title

Partner

Phone

(386) 218-4993

Specialties & licenses 1

Addresses

Other names 1

• legacy pharmacy oc Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Tax ID family

Legacy Pharmacy Oc2 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.

• Legacy Pharmacy Oc LLC

  • Long Term Care Pharmacy
  • Orange City, FL
  • NPI 1154101731
  NPD tax ID

Locations

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 1

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

• Diptiben Smart

  • Pharmacist
  • Orange City, FL
  • NPI 1497347546
  NPD (past)

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

{
    "created_epoch": "1366329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695600000000",
    "number": "1487098513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 TOWN CENTER DR STE 100",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327638266",
            "telephone_number": "862-184-9933",
            "fax_number": "386-218-4913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 TOWN CENTER DR STE 100",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327638266",
            "telephone_number": "386-218-4993",
            "fax_number": "386-218-4913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY PHARMACY OC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-19",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-25",
        "status": "A",
        "authorized_official_last_name": "SMART",
        "authorized_official_first_name": "DIPTI",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "386-218-4993",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PHARM.D"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "legacy pharmacy oc",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "legacy pharmacy oc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tricia Keelan Lechmaier, D.C.
• Anzen U. Lee, CRNA
• Victor Kwok Hung Lee, PHARM.D.
• Traci Lefferts
• Legacy Pharmacy Oc LLC
• Guylaine Legault, ARNP
• Marissa Lemay, PTA
• Ashley Danielle Lenzen
• Lisa Marie Lepine, PT, DPT
• Laurie Dianne Letizia, PA-C

• All providers in Orange City, FL
• Community/Retail Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2023; 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.