Brashears Vital Care Corp

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PH22730 Issued in FL

Legal business name

BRASHEARS VITAL CARE CORP

Practice address

471 N Dacie PT
Lecanto, FL 34461

Phone

(352) 746-3420

Fax

(352) 746-6741

NPI assigned

Jun 22, 2007

Organization subpart

No

Name

Jesse Brashear

Title

Director

Phone

(352) 637-2079

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Brashears Vital Care Corp

  • Community/Retail Pharmacy
  • Inverness, FL
  • NPI 1710912662

  9931006202

  Same PAC ID

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

• David Thomas John Stimson, PHARMD

  • Pharmacist
  • Lecanto, FL
  • NPI 1619690963
  NPD (past)

Medicare fee-for-service enrollment

Enrolled in FL

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)…
• 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)

• Brashear's Pharmacy Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 11, 2014.

{
    "created_epoch": "1182470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410393600000",
    "number": "1679779185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "471 N DACIE PT",
            "city": "LECANTO",
            "state": "FL",
            "postal_code": "34461",
            "telephone_number": "352-746-3420",
            "fax_number": "352-746-6741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "471 N DACIE PT",
            "city": "LECANTO",
            "state": "FL",
            "postal_code": "34461",
            "telephone_number": "352-746-3420",
            "fax_number": "352-746-6741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRASHEARS VITAL CARE CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-22",
        "last_updated": "2014-09-11",
        "status": "A",
        "authorized_official_last_name": "BRASHEAR",
        "authorized_official_first_name": "JESSE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "352-637-2079"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH22730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brashear's Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ashley Danielle Boardman
• Brian Keith Bonomo, PAC
• Shenevia Nichole Bostick
• Mary Beth Bottorf, APRN
• Timothy A Brant, M.D.
• Megan Brecher, APRN
• Brentwood Health Care Associates LLC
• Brentwood Meadow Health Care Associates LLC
• Brentwoodmeadowhealthcareassodbabrentwood Retirement Community
• Charles F. Brinegar Jr., ARNP

• All providers in Lecanto, FL
• Community/Retail Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2014; 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.