NPIMap

Organization Active NPI

SKP LLC

  • Community/Retail Pharmacy
  • Gulfport, FL
National Provider Identifier
1730598293
Registry record updated Apr 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
SKP LLC
Practice address
5004 Gulfport Blvd S
Gulfport, FL 33707-4942
Phone
(727) 223-1075
Fax
(727) 388-8217
NPI assigned
Aug 9, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2015

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

Authorized official

Name
Mr. Tapan Patel, PHARMACISTNPI 1356781009
Title
Pharmacist in Charge
Phone
(727) 223-1075

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

5004 Gulfport Blvd S
Gulfport, FL 33707-4942

Mailing address

5004 Gulfport Blvd S
Gulfport, FL 33707-4942
Phone (727) 223-1075

Other identifiers 1

IdentifierTypeStateIssuer
PH28610OtherFLSTATE OF FLORIDA, DEPARTMENT OF HEALTH, PHARMACY LICENSE

Other names 1

  • GULFPORT PHARMACY Doing business as

National Provider Directory

National Provider Directory

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)…

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1407542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427846400000",
    "number": "1730598293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5004 GULFPORT BLVD S",
            "city": "GULFPORT",
            "state": "FL",
            "postal_code": "337074942",
            "telephone_number": "727-223-1075",
            "fax_number": "727-388-8217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5004 GULFPORT BLVD S",
            "city": "GULFPORT",
            "state": "FL",
            "postal_code": "337074942",
            "telephone_number": "727-223-1075",
            "fax_number": "727-388-8217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-09",
        "last_updated": "2015-04-01",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "TAPAN",
        "authorized_official_title_or_position": "PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "727-223-1075",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHARMACIST"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF FLORIDA, DEPARTMENT OF HEALTH, PHARMACY LICENSE",
            "identifier": "PH28610",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GULFPORT PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gulfport, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2015; 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.