Commcare Pharmacy-FTL LLC

Primary specialty

PharmacyTaxonomy code 333600000X

License

106493 Issued in AK

Legal business name

COMMCARE PHARMACY-FTL LLC

Practice address

855 SW 78TH Ave
Ste C100
Plantation, FL 33324-3223

Phone

(954) 568-6212

Fax

(954) 568-2765

NPI assigned

Jun 30, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Robert George Raffalo Jr.

Title

C.O.O.

Phone

(954) 284-2384

Specialties & licenses 15

Addresses

Other identifiers 4

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

• Commcare Pharmacy Mia LLC

  • Specialty Pharmacy
  • Miami, FL
  • NPI 1063423606

  Member Of

  NPD member
• Dignity Health

  • Neurological Surgery Physician
  • Henderson, NV
  • NPI 1720358039

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1598762015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 SW 78TH AVE",
            "address_2": "STE C100",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "33324",
            "telephone_number": "954-568-6212",
            "fax_number": "954-568-2765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 SW 78TH AVE",
            "address_2": "STE C100",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333243223",
            "telephone_number": "954-568-6212",
            "fax_number": "954-568-2765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMCARE PHARMACY-FTL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-30",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "RAFFALO",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "GEORGE",
        "authorized_official_title_or_position": "C.O.O.",
        "authorized_official_telephone_number": "954-284-2384",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "DC",
            "license": "NRX0000870",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "IL",
            "license": "054.016610",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "DE",
            "license": "A9-0001012",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "IA",
            "license": "3817",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "FL",
            "license": "PH21660",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "IN",
            "license": "64000929A",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "GA",
            "license": "PHNR000479",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "CT",
            "license": "897",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "KS",
            "license": "22-44984",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "HI",
            "license": "PMP591",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "CO",
            "license": "5788",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "AZ",
            "license": "Y005081",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "AK",
            "license": "106493",
            "primary": true
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "CA",
            "license": "NRP1817",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "ID",
            "license": "2293MS",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "031179100",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "691438100",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "031179101",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2010319",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pharmacy in Plantation, FL
• Providers in Plantation, FL by specialty
• Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.