West Palm Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PH25847 Issued in FL

Legal business name

WEST PALM PHARMACY LLC

Practice address

5760 Okeechobee Blvd
West Palm Beach, FL 33417-4343

Phone

(561) 249-2130

Fax

(561) 249-2104

NPI assigned

Dec 23, 2011

Organization subpart

No

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

Authorized official

Name

Salim Soufan, RPH

Title

Pharmacist/Owner

Phone

(561) 249-2130

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• West Palm Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Networks

• Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Maximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
• HealthSun Health Plans Network
• Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

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

{
    "created_epoch": "1324598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354147200000",
    "number": "1619246378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5760 OKEECHOBEE BLVD",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334174343",
            "telephone_number": "561-249-2130",
            "fax_number": "561-249-2104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5760 OKEECHOBEE BLVD",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334174343",
            "telephone_number": "561-249-2130",
            "fax_number": "561-249-2104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST PALM PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-23",
        "last_updated": "2012-11-29",
        "status": "A",
        "authorized_official_last_name": "SOUFAN",
        "authorized_official_first_name": "SALIM",
        "authorized_official_title_or_position": "PHARMACIST/OWNER",
        "authorized_official_telephone_number": "561-249-2130",
        "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": "PH25847",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "5708485",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Palm Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• West Palm Dermatology and Skincare Center LLC
• West Palm Dialysis, LLC
• West Palm Dialysis, LLC
• West Palm General
• West Palm Outpatient Surgery and Laser Center LTD
• West Palm Rehab & Medical Center Inc
• West Palm Wellness, Inc.
• Sierra West, APRN
• Michael Charles Westcott, DDS
• Nils Erik Westerlund, P.T.

• Community/Retail Pharmacy in West Palm Beach, FL
• Providers in West Palm Beach, 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 Nov 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.