NPIMap

Organization Active NPI

Humana Medical Plan Inc

  • Clinic Pharmacy
  • Hollywood, FL
National Provider Identifier
1699790170
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic PharmacyTaxonomy code 3336C0002X
License
PH09985 Issued in FL
Legal business name
HUMANA MEDICAL PLAN INC
Doing business as
HUMANA PHARMACY 47906
Practice address
2216 Hollywood Blvd
Hollywood, FL 33020-6702
Phone
(954) 926-2914
Fax
(954) 926-2957
NPI assigned
Jul 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Stephanie Wallace
Title
Manager
Phone
(954) 926-2914

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X PH09985 FL Primary

Addresses

Primary practice location

2216 Hollywood Blvd
Hollywood, FL 33020-6702

Mailing address

2216 Hollywood Blvd
Hollywood, FL 33020-6702

Other identifiers 1

IdentifierTypeStateIssuer
1071959OtherOTHER ID NUMBER-COMMERCIAL NUMBER

Other names 1

  • HUMANA PHARMACY 47906 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Humana Medical Plan Inc53 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1699790170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2216 HOLLYWOOD BLVD",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330206702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2216 HOLLYWOOD BLVD",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330206702",
            "telephone_number": "954-926-2914",
            "fax_number": "954-926-2957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUMANA MEDICAL PLAN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "954-926-2914"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "FL",
            "license": "PH09985",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "1071959",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HUMANA PHARMACY 47906",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hollywood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.