Pine Brook Pharmacy LLC

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

Legal business name

PINE BROOK PHARMACY LLC

Doing business as

Pine Brook Pharmacy

Practice address

14111 Cortez Blvd
Brooksville, FL 34613-2707

Phone

(352) 610-4347

Fax

(352) 610-4349

NPI assigned

Feb 22, 2022

Organization subpart

No

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

Authorized official

Name

Dorothy Schmeckpeper

Title

Pharmacy Supervisor

Phone

(352) 610-4347

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Pine Brook Pharmacy Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gautam Thakkar, RPH

  • Pharmacist
  • Lutz, FL
  • NPI 1194914572
  NPD

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

{
    "created_epoch": "1645488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645488000000",
    "number": "1588310239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14111 CORTEZ BLVD",
            "city": "BROOKSVILLE",
            "state": "FL",
            "postal_code": "346132707",
            "telephone_number": "352-610-4347",
            "fax_number": "352-610-4349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14111 CORTEZ BLVD",
            "city": "BROOKSVILLE",
            "state": "FL",
            "postal_code": "346132707",
            "telephone_number": "352-610-4347",
            "fax_number": "352-610-4349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINE BROOK PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-22",
        "last_updated": "2022-02-22",
        "certification_date": "2022-02-02",
        "status": "A",
        "authorized_official_last_name": "SCHMECKPEPER",
        "authorized_official_first_name": "DOROTHY",
        "authorized_official_title_or_position": "PHARMACY SUPERVISOR",
        "authorized_official_telephone_number": "352-610-4347"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001168201",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pine Brook Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mallik A Piduru, M.D.
• Edward Russell Pierce
• Isabel Pietras
• Debra Jean Pilla
• Pine Brook Pharmacy LLC
• Jesus Manuel Pinero Jr.
• Terry P Pitts, ARNP
• Joseph Raymond Plouffe, DO
• Stephen Plummer, ARNP
• Franklin Albright Poff III, D.O.

• Long Term Care Pharmacy in Brooksville, FL
• Providers in Brooksville, FL by specialty
• Long Term Care Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2022; 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.