Balls Rexall Drugs Inc
Organization Active NPI Pharmacy · Casselberry, FL
NPI 1801908736 · NPPES record last updated Jan 21, 2025
Key facts
- NPI
- 1801908736
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pharmacy 333600000X
- Legal business name
- BALLS REXALL DRUGS INC
- Practice address
- 500 S.R. 436
Suite 2074
Casselberry, FL 32707 - Phone
- (352) 726-1021
- Fax
- (352) 726-4688
- NPI assigned
- Aug 31, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Kenneth L Heimann, RPH
- Title
- President/Pharmacist
- Phone
- (352) 726-1021
Subparts reporting this organization as parent 1
Practitioners 1
-
Kenneth Heimann, R.PH.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20101110001356 | FL | Part B Supplier - Pharmacy | 7618095571 | Practice locations: Casselberry, FL |
| O20220222002737 | FL | Part B Supplier - Independent Clinical Laboratory | 7618095571 | Practice locations: Inverness, FL |
National Provider Directory
Locations
500 State Road 436
Ste 2074
Casselberry, FL 32707
Phone (352) 726-1021
214 S Highway 41
Inverness, FL 34450
Networks
- Optimum HealthCare HMO Network
- Freedom Health HMO Network
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | Yes | ||
| Community/Retail Pharmacy | 3336C0003X | PH11930 | FL | |
| Long Term Care Pharmacy | 3336L0003X |
Addresses
Primary practice location
500 S.R. 436
Suite 2074
Casselberry, FL 32707
Mailing address
500 S.R. 436
Suite 2074
Casselberry, FL 32707
Phone (352) 726-1021
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 103431600 | Medicaid | FL | |
| 2004479 | Other | PK |
Other names
- B&W Rexall Drugs
Other providers in Casselberry, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 21, 2025. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.