Fisher Pharmacy, Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PH000185 Issued in FL

Legal business name

FISHER PHARMACY, INC

Practice address

688 Baldwin Ave
Defuniak Springs, FL 32435-2596

Phone

(850) 892-5612

Fax

(850) 892-5089

NPI assigned

Feb 7, 2007

Last updated

Feb 6, 2015By 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

Mr. John Michael Roehm, RPHNPI 1346262367

Title

President

Phone

(850) 892-5612

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• John Michael Roehm, RPH

  • Pharmacist
  • Defuniak Springs, FL
  • NPI 1346262367
  NPD Authorized official
• Katelyn Tidwell, PHARMD

  • Pharmacist
  • Defuniak Springs, FL
  • NPI 1497347496
  NPD
• Morgan Roehm

  • Pharmacist
  • Defuniak Springs, FL
  • NPI 1366034365
  NPD (past)

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423180800000",
    "number": "1861532145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "688 BALDWIN AVE",
            "city": "DEFUNIAK SPRINGS",
            "state": "FL",
            "postal_code": "324352596",
            "telephone_number": "850-892-5612",
            "fax_number": "850-892-5089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "688 BALDWIN AVE",
            "city": "DEFUNIAK SPRINGS",
            "state": "FL",
            "postal_code": "324352596",
            "telephone_number": "850-892-5612",
            "fax_number": "850-892-5089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FISHER PHARMACY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2015-02-06",
        "status": "A",
        "authorized_official_last_name": "ROEHM",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "850-892-5612",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH000185",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104725600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID-DME",
            "identifier": "104725601",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fawaz Medical and Surgical Clinic, LLC
• Fawzi Fawaz, M. D.
• Patricia A Ferman, MS, RD, LD
• Maria Loreto Fernandez Puig
• Kendall Lynton Fields, PHD, LMHC
• Meredith Ariel Flanagan, NP
• Ashley Fleming
• Florida Department of Health (Walton Community Health Center)
• Florida Department of Health
• Molly B Fulmer

• Community/Retail Pharmacy in Defuniak Springs, FL
• Providers in Defuniak Springs, 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 Feb 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.