Individual provider Active NPI

Latoya Renee Wilcox, RPH

  • Pharmacist
  • Plant City, FL
National Provider Identifier
1508460890
Registry record updated Nov 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS59207 Issued in FL
Practice address
403 N Alexander St
Plant City, FL 33563-4305
Phone
(813) 659-4687
Fax
(813) 707-1778
NPI assigned
Nov 26, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS59207 FL Primary

Addresses

Primary practice location

403 N Alexander St
Plant City, FL 33563-4305

Mailing address

403 N Alexander St
Plant City, FL 33563-4305
Phone (813) 659-4687

Other identifiers 1

IdentifierTypeStateIssuer
PS59207OtherFLRPH

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Cvs Holiday CVS LLC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
PS59207FLMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Holiday CVS LLC PastSince Nov 29, 2020 Accepting new patients
Holiday CVS L.L.C. PastSince Nov 29, 2020 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1606348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606348800000",
    "number": "1508460890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 N ALEXANDER ST",
            "city": "PLANT CITY",
            "state": "FL",
            "postal_code": "335634305",
            "telephone_number": "813-659-4687",
            "fax_number": "813-707-1778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 N ALEXANDER ST",
            "city": "PLANT CITY",
            "state": "FL",
            "postal_code": "335634305",
            "telephone_number": "813-659-4687",
            "fax_number": "813-707-1778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILCOX",
        "first_name": "LATOYA",
        "middle_name": "RENEE",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-26",
        "last_updated": "2020-11-26",
        "certification_date": "2020-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS59207",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RPH",
            "identifier": "PS59207",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Cvs",
            "affiliation": "Y",
            "affiliationName": "Holiday CVS LLC",
            "address_1": "403 N Alexander St",
            "city": "Plant City",
            "state": "FL",
            "country_code": "US",
            "postal_code": "335634305",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Plant City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2020; 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.