Extended Care Pharmacy East Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PH26112 Issued in FL

Legal business name

EXTENDED CARE PHARMACY EAST INC

Practice address

305 S US Highway 17
East Palatka, FL 32131-4092

Phone

(386) 326-4487

Fax

(386) 326-4437

NPI assigned

Nov 10, 2011

Organization subpart

No

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

Authorized official

Name

Mark Casey Phillips

Title

CPT/Owner

Phone

(386) 326-4487

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• EXTENDED CARE PHARMACY EAST inc Doing business as

Locations

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

{
    "created_epoch": "1320883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344297600000",
    "number": "1821375460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 S US HIGHWAY 17",
            "city": "EAST PALATKA",
            "state": "FL",
            "postal_code": "321314092",
            "telephone_number": "386-326-4487",
            "fax_number": "386-326-4437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 S US HIGHWAY 17",
            "city": "EAST PALATKA",
            "state": "FL",
            "postal_code": "321314092",
            "telephone_number": "386-326-4487",
            "fax_number": "386-326-4437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXTENDED CARE PHARMACY EAST INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-10",
        "last_updated": "2012-08-07",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "CASEY",
        "authorized_official_title_or_position": "CPT/OWNER",
        "authorized_official_telephone_number": "386-326-4487"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH26112",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "5708118",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EXTENDED CARE PHARMACY EAST inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in East Palatka, FL
• Providers in East Palatka, 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 Aug 7, 2012; 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.