NPIMap

Organization Active NPI

Davita Medical Florida, Inc.

Doing business as DaVita Medical Group, Pharmacy

  • Specialty Pharmacy
  • New Port Richey, FL
National Provider Identifier
1508138769
Registry record updated May 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Specialty PharmacyTaxonomy code 3336S0011X
License
18603 Issued in FL
Legal business name
DAVITA MEDICAL FLORIDA, INC.
Doing business as
DaVita Medical Group, Pharmacy
Practice address
4757 US Highway 19 Ste a
New Port Richey, FL 34652-4945
Phone
(727) 849-9373
Fax
(727) 815-1203
NPI assigned
Feb 3, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2017

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

Authorized official

Name
James Hilger
Title
Chief Accounting Officer
Phone
(253) 973-0777

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Specialty Pharmacy 3336S0011X 18603 FL Primary

Addresses

Primary practice location

4757 US Highway 19 Ste a
New Port Richey, FL 34652-4945

Mailing address

10051 5TH Street North
St. Petersburg, FL 33702-2299
Phone (727) 824-0780

Other identifiers 1

IdentifierTypeStateIssuer
2133637OtherPK

Other names 1

  • DaVita Medical Group, Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Davita Medical Group13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

NPI Registry JSON

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

{
    "created_epoch": "1328227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494374400000",
    "number": "1508138769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10051 5TH STREET NORTH",
            "city": "ST. PETERSBURG",
            "state": "FL",
            "postal_code": "337022299",
            "telephone_number": "727-824-0780",
            "fax_number": "727-828-2321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4757 US HIGHWAY 19 STE A",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "346524945",
            "telephone_number": "727-849-9373",
            "fax_number": "727-815-1203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVITA MEDICAL FLORIDA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-03",
        "last_updated": "2017-05-10",
        "status": "A",
        "authorized_official_last_name": "HILGER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CHIEF ACCOUNTING OFFICER",
        "authorized_official_telephone_number": "253-973-0777"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "FL",
            "license": "18603",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2133637",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DaVita Medical Group, Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New Port Richey, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2017; 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.