Mulberry Pharmacy Inc

Key facts

NPI

1609973445

Entity type

Organization (NPI type 2)

Primary specialty

Community/Retail Pharmacy 3336C0003X

License

PH0001028 (FL)

Legal business name

MULBERRY PHARMACY INC

Practice address

1009 N Church Ave
Mulberry, FL 33860-2039

Phone

(863) 425-1101

Fax

(863) 425-1497

NPI assigned

Sep 20, 2006

Organization subpart

No

Authorized official

Name

Jerold Slaughter, RPH

Title

Owner Ceo

Phone

(863) 425-1101

Practitioners 2

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

• Robert Paul Dickerson Pharmacist · Mulberry, FL · NPI 1831254143
  NPD (past)
• David Michael Swager, RPH. Pharmacist · Mulberry, FL · NPI 1790039675
  NPD (past)

National Provider Directory

Locations

Specialties & licenses

Addresses

Other identifiers

Other names

• MULBERRY PHARMACY INC Doing business as

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 4, 2017.

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491264000000",
    "number": "1609973445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 767",
            "city": "MULBERRY",
            "state": "FL",
            "postal_code": "338600767",
            "telephone_number": "863-425-1101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1009 N CHURCH AVE",
            "city": "MULBERRY",
            "state": "FL",
            "postal_code": "338602039",
            "telephone_number": "863-425-1101",
            "fax_number": "863-425-1497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MULBERRY PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2017-04-04",
        "status": "A",
        "authorized_official_last_name": "SLAUGHTER",
        "authorized_official_first_name": "JEROLD",
        "authorized_official_title_or_position": "OWNER CEO",
        "authorized_official_telephone_number": "863-425-1101",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH0001028",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100004700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2005824",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MULBERRY PHARMACY INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mulberry, FL

• Viviana Patricia Mora, DMD
• Ashley Morin
• Mulberry Dental Care Inc.
• Mulberry Food and Pharmacy LLC
• Mulberry LTC Pharmacy, LLC
• Steven Lamar Nichols, CSFA
• Cruz Migdalia Nieves
• Luis Abraham Pardo
• Rakesh M Patel
• Teresa Perez, CARGIVER

All providers in Mulberry, FL · Community/Retail Pharmacy in Florida