NPIMap

Organization Active NPI

BSN Health

  • Community/Retail Pharmacy
  • Davenport, FL
National Provider Identifier
1760017487
Registry record updated Mar 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
BSN HEALTH
Practice address
45665 Highway 27
Davenport, FL 33897-4546
Phone
(863) 866-9660
Fax
(863) 353-1190
NPI assigned
Mar 4, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2020

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

Authorized official

Name
Narsi Hatam Pour
Title
Vice President
Phone
(863) 866-9660

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

45665 Highway 27
Davenport, FL 33897-4546

Mailing address

45665 Highway 27
Davenport, FL 33897-4546
Phone (863) 866-9660

Other identifiers 1

IdentifierTypeStateIssuer
PH32608OtherFLBOARD OF PHARMACY LICENSE

Other names 1

  • Family Care Clinic Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
BSN Health2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

45665 Highway 27
Davenport, FL 33897
Phone (863) 866-9660

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)

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

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": "1583280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583280000000",
    "number": "1760017487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45665 HIGHWAY 27",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338974546",
            "telephone_number": "863-866-9660",
            "fax_number": "863-353-1190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45665 HIGHWAY 27",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338974546",
            "telephone_number": "863-866-9660",
            "fax_number": "863-353-1190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BSN HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-04",
        "last_updated": "2020-03-04",
        "certification_date": "2020-03-04",
        "status": "A",
        "authorized_official_last_name": "HATAM POUR",
        "authorized_official_first_name": "NARSI",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "863-866-9660"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF PHARMACY LICENSE",
            "identifier": "PH32608",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Care Clinic Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Davenport, FL

Sources for this page

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