North Florida Pharmacy, Inc.
Organization Active NPI Community/Retail Pharmacy · Lake City, FL
NPI 1790795581 · NPPES record last updated Nov 3, 2020
Key facts
- NPI
- 1790795581
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- PH12595 (FL)
- Legal business name
- NORTH FLORIDA PHARMACY, INC.
- Practice address
- 347 SW Main Blvd
Suite 102
Lake City, FL 32025-5262 - Phone
- (386) 758-6770
- Fax
- (386) 758-9413
- NPI assigned
- Aug 8, 2006
- Organization subpart
- No
Authorized official
- Name
- Joel E. Rosenfeld, RPH
- Title
- Co-Owner/VP/Pharmacist
- Phone
- (386) 758-6770
Other NPIs on the same Medicare enrollment 1
Corporate family (same tax ID) 1
Member organizations 2
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 10D2210234 | North Florida Pharmacy Inc | Certificate of waiver | Jan 19, 2027 |
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| North Florida Pharmacy, Inc. |
Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order) | Does not accept assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930052869 | FL | DME Supplier - Pharmacy | 5991824864 | Practice locations: Lake City, FL |
| O20120111000929 | FL | Part B Supplier - Pharmacy | 5991824864 |
1 other NPI on this enrollment Practice locations: Lake City, FL |
National Provider Directory
- Tax ID family
- North Florida Pharmacy Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | PH12595 | FL | |
| Community/Retail Pharmacy | 3336C0003X | PH12595 | FL | Yes |
Addresses
Primary practice location
347 SW Main Blvd
Suite 102
Lake City, FL 32025-5262
Mailing address
347 SW Main Blvd
Suite 102
Lake City, FL 32025-5262
Phone (386) 758-6770
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 102637200 | Medicaid | FL | |
| 102637201 | Medicaid | FL |
Other names
- NORTH FLORIDA PHARMACY
Other providers in Lake City, FL
- North Florida Neurodiagnostics, LLC
- North Florida Pediatrics, PA
- North Florida Pediatrics, PA.
- North Florida Pharmacy, Inc.
- North Florida Pharmacy, Inc.
- North Florida Primary Care PLLC
- North Florida Radiation Oncology
- North Florida Rehabilitation, Inc.
- North Florida Surgery Center Inc
- North Florida Surgery Center Inc
All providers in Lake City, FL · Community/Retail Pharmacy in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 3, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.