Old Town Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

OLD TOWN PHARMACY INC

Practice address

26064 US- 19
Old Town, FL 32680

Phone

(386) 758-6770

NPI assigned

Oct 26, 2018

Last updated

Oct 21, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Terry Hodgkinson

Title

Bookkeeper

Phone

(386) 758-6770

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1540512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571616000000",
    "number": "1770050965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1756 SW BARNETT WAY",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320256953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26064 US- 19",
            "city": "OLD TOWN",
            "state": "FL",
            "postal_code": "32680",
            "telephone_number": "386-758-6770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLD TOWN PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-26",
        "last_updated": "2019-10-21",
        "status": "A",
        "authorized_official_last_name": "HODGKINSON",
        "authorized_official_first_name": "TERRY",
        "authorized_official_title_or_position": "BOOKKEEPER",
        "authorized_official_telephone_number": "386-758-6770"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• April Dawn Lovelady
• Larry Kevin Maynard
• Medicaid Made Simple, Inc
• Marwa Mekdashi
• Old Town Pharmacy Inc
• Eileen Maureen Patterson
• Tess Rogers, LMT, CYT200
• Lisa Lynn Rollison
• Susan Lee Rowe, ARNP
• Jessica Christine Soares

• Community/Retail Pharmacy in Old Town, FL
• Providers in Old Town, 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 Oct 21, 2019; 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.