Alpha-Omega Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PH26538 Issued in FL

Legal business name

ALPHA-OMEGA PHARMACY

Doing business as

Alpha-Omega Pharmacy, L.L.C.

Practice address

4625 E Bay Dr Ste 313
Clearwater, FL 33764-5747

Phone

(844) 557-0835

Fax

(800) 563-2710

NPI assigned

Dec 3, 2012

Last updated

Mar 31, 2017By 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

Bryan Holmes

Title

Owner

Phone

(844) 557-0835

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Alpha-Omega Pharmacy, L.L.C. Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Locations

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

{
    "created_epoch": "1354492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490918400000",
    "number": "1770828741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4625 E BAY DR STE 313",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337645747",
            "telephone_number": "844-557-0835",
            "fax_number": "800-563-2710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4625 E BAY DR STE 313",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337645747",
            "telephone_number": "844-557-0835",
            "fax_number": "800-563-2710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALPHA-OMEGA PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-03",
        "last_updated": "2017-03-31",
        "status": "A",
        "authorized_official_last_name": "HOLMES",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "844-557-0835"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH26538",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2138070",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008459101",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008459100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alpha-Omega Pharmacy, L.L.C.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Clearwater, FL
• Providers in Clearwater, 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 Mar 31, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.