Suntree Pharmacy

Primary specialty

PharmacistTaxonomy code 183500000X

Legal business name

SUNTREE PHARMACY

Practice address

7640 N. Wickham Rd #117
Melbourne, FL 32940

Phone

(321) 253-3535

Fax

(321) 253-2522

NPI assigned

Dec 8, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Diahn Clark

Title

Owner

Phone

(321) 253-3535

Specialties & licenses 2

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1548329014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7640 N. WICKHAM RD #117",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "32940",
            "telephone_number": "321-253-3535",
            "fax_number": "321-253-2522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7640 N. WICKHAM RD #117",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "32940",
            "telephone_number": "321-253-3535",
            "fax_number": "321-253-2522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNTREE PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-08",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "DIAHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "321-253-3535",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PH18030",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pharmacist",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY LICENSE",
            "identifier": "PH18030",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000042400",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "026219600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pharmacist in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Pharmacist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.