Park Avenue Pharmacy, Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PH20089 Issued in FL

Legal business name

PARK AVENUE PHARMACY, INC.

Practice address

5440 Dogwood Dr
Milton, FL 32570-3700

Phone

(850) 623-2222

Fax

(850) 981-9445

NPI assigned

Nov 2, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Tracey Perry Chastain, RPH

Title

Owner

Phone

(850) 623-2222

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201132800000",
    "number": "1538248562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5440 DOGWOOD DR",
            "city": "MILTON",
            "state": "FL",
            "postal_code": "325703700",
            "telephone_number": "850-623-2222",
            "fax_number": "850-981-9445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5440 DOGWOOD DR",
            "city": "MILTON",
            "state": "FL",
            "postal_code": "325703700",
            "telephone_number": "850-623-2222",
            "fax_number": "850-981-9445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK AVENUE PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2008-01-24",
        "status": "A",
        "authorized_official_last_name": "CHASTAIN",
        "authorized_official_first_name": "TRACEY",
        "authorized_official_middle_name": "PERRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "850-623-2222",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH20089",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "1006217",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS-FL",
            "identifier": "D8452",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Community/Retail Pharmacy in Milton, FL
• Providers in Milton, FL by specialty
• Community/Retail Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2008; 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.