Oviedo Pharmacy and Drug Store LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

OVIEDO PHARMACY AND DRUG STORE LLC

Doing business as

Pharmacy on the Park

Practice address

784 S. Central Ave
Oviedo, FL 32765-3276

Phone

(407) 977-9779

NPI assigned

Mar 22, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Ian Tasman

Title

Pharmacist

Phone

(407) 977-9779

Specialties & licenses 3

Addresses

Other names 1

• Pharmacy on the Park Doing business as

Medicare fee-for-service enrollment

Enrolled in FL3 enrollments

Enrollment records 3

Tax ID family

Oviedo Pharmacy and Drug Store LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Oviedo Pharmacy and Drug Store LLC

  • Mail Order Pharmacy
  • Oviedo, FL
  • NPI 1417700550
  NPD tax ID
• Oviedo Pharmacy and Drug Store LLC

  • Long Term Care Pharmacy
  • Oviedo, FL
  • NPI 1760284178
  NPD tax ID

Networks

• 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)
• 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)…

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

{
    "created_epoch": "1616371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732579200000",
    "number": "1720664709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "784 S CENTRAL AVE",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327658060",
            "telephone_number": "407-977-9779",
            "fax_number": "407-977-0079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "784 S. CENTRAL AVE",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327653276",
            "telephone_number": "407-977-9779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OVIEDO PHARMACY AND DRUG STORE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-22",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A",
        "authorized_official_last_name": "TASMAN",
        "authorized_official_first_name": "IAN",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "407-977-9779",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pharmacy on the Park",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pharmacy on the Park",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Oviedo, FL
• Providers in Oviedo, 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 26, 2024; 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.