NPIMap

Organization Active NPI

Seminole Pharmacy

  • Clinic Pharmacy
  • Immokalee, FL
National Provider Identifier
1750006656
Registry record updated Oct 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic PharmacyTaxonomy code 3336C0002X
Legal business name
SEMINOLE PHARMACY
Practice address
850 Seminole Crossing TRL
Immokalee, FL 34142-4307
Phone
(239) 867-3440
NPI assigned
Oct 4, 2022
Organization subpart
Yes
Parent organization
SEMINOLE TRIBE OF FLORIDA HEALTH DEPARTMENTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 4, 2022

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

Authorized official

Name
Vandhana Bhagwan Kiswani-Barley, MD
Title
Executive Director
Phone
(863) 985-5151

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X Primary

Addresses

Primary practice location

850 Seminole Crossing TRL
Immokalee, FL 34142-4307

Mailing address

6401 Sheridan St
Hollywood, FL 33024-4156
Phone (954) 965-1331

Other names 1

  • SEMINOLE PHARMACY (IMK) Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address monicaoban@semtribe.com

National Provider Directory

National Provider Directory
Tax ID family
Seminole Tribe of Florida9 organizations share this tax ID, including this one
Part of
Seminole Tribe of Florida

Other organizations with this tax ID 8

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

Locations

6401 Sheridan St
Hollywood, FL 33024
Phone (954) 961-7210

850 Seminole Crossing Trl
Immokalee, FL 34142
Phone (239) 867-3440

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1664841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664841600000",
    "number": "1750006656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6401 SHERIDAN ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330244156",
            "telephone_number": "954-965-1331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 SEMINOLE CROSSING TRL",
            "city": "IMMOKALEE",
            "state": "FL",
            "postal_code": "341424307",
            "telephone_number": "239-867-3440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEMINOLE PHARMACY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SEMINOLE TRIBE OF FLORIDA HEALTH DEPARTMENT",
        "enumeration_date": "2022-10-04",
        "last_updated": "2022-10-04",
        "certification_date": "2022-09-13",
        "status": "A",
        "authorized_official_last_name": "KISWANI-BARLEY",
        "authorized_official_first_name": "VANDHANA",
        "authorized_official_middle_name": "BHAGWAN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "863-985-5151",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "monicaoban@semtribe.com",
            "affiliation": "N",
            "address_1": "850 Seminole Crossing Trl",
            "city": "Immokalee",
            "state": "FL",
            "country_code": "US",
            "postal_code": "341424307",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "SEMINOLE PHARMACY (IMK)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Immokalee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2022; 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.