Blue Sky Discount Pharmacy LLC

Primary specialty

PharmacyTaxonomy code 333600000X

License

PH24968 Issued in FL

Legal business name

BLUE SKY DISCOUNT PHARMACY LLC

Practice address

115 Hickory St
Suite #101
West Melbourne, FL 32904-3505

Phone

(321) 914-0823

Fax

(321) 914-0824

NPI assigned

Nov 24, 2010

Last updated

Mar 3, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Deadra Thornton-Wright

Title

Owner

Phone

(321) 914-0823

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1290556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425340800000",
    "number": "1508168576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 HICKORY ST",
            "address_2": "SUITE #101",
            "city": "WEST MELBOURNE",
            "state": "FL",
            "postal_code": "329043505",
            "telephone_number": "321-914-0823",
            "fax_number": "321-914-0824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 HICKORY ST",
            "address_2": "SUITE #101",
            "city": "WEST MELBOURNE",
            "state": "FL",
            "postal_code": "329043505",
            "telephone_number": "321-914-0823",
            "fax_number": "321-914-0824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE SKY DISCOUNT PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-24",
        "last_updated": "2015-03-03",
        "status": "A",
        "authorized_official_last_name": "THORNTON-WRIGHT",
        "authorized_official_first_name": "DEADRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "321-914-0823"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "FL",
            "license": "PH24968",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003753900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pharmacy in West Melbourne, FL
• Providers in West Melbourne, FL by specialty
• Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2015; 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.