Organization Active NPI

Belleview Community Pharmacy, LLC

  • Pharmacist
  • Leesburg, FL
National Provider Identifier
1497713812
Registry record updated Oct 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH21895 Issued in FL
Legal business name
BELLEVIEW COMMUNITY PHARMACY, LLC
Practice address
2500 Citrus Blvd.
Leesburg, FL 34748-3063
Phone
(352) 728-0477
Fax
(352) 315-3836
NPI assigned
May 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2012

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

Authorized official

Name
Michael Crimi Jr., P.A.
Title
Manager/Owner
Phone
(352) 427-8680

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 183500000X PH21895 FL Primary

Addresses

Primary practice location

2500 Citrus Blvd.
Leesburg, FL 34748-3063

Mailing address

10762 SE US Hwy 441
Belleview, FL 34420-3805
Phone (352) 347-4064

Other identifiers 3

IdentifierTypeStateIssuer
031408100MedicaidFL
031408101MedicaidFL
1094185OtherNCPDP PROVIDER ID #

Other names 1

  • Belleview Community Pharmacy, Inc. Former legal business name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350950400000",
    "number": "1497713812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10762 SE US HWY 441",
            "city": "BELLEVIEW",
            "state": "FL",
            "postal_code": "344203805",
            "telephone_number": "352-347-4064",
            "fax_number": "352-347-6832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 CITRUS BLVD.",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347483063",
            "telephone_number": "352-728-0477",
            "fax_number": "352-315-3836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELLEVIEW COMMUNITY PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-03",
        "last_updated": "2012-10-23",
        "status": "A",
        "authorized_official_last_name": "CRIMI",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "MANAGER/OWNER",
        "authorized_official_telephone_number": "352-427-8680",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "P.A."
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PH21895",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "031408100",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "031408101",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER ID #",
            "identifier": "1094185",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Belleview Community Pharmacy, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Leesburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2012; 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.