Dutta LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PH24140 Issued in FL

Legal business name

DUTTA LLC

Doing business as

Healthmed Pharmacy

Practice address

1839 Central Ave
Saint Petersburg, FL 33713-8900

Phone

(727) 894-3001

Fax

(727) 894-3000

NPI assigned

Jun 24, 2009

Last updated

Jan 20, 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

Vishal Malkan

Title

Managing Member

Phone

(813) 285-9365

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• HEALTHMED PHARMACY Doing business as

Locations

Networks

• Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Máximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
• Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

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.

• Khien Pham

  • Pharmacist
  • St Petersburg, FL
  • NPI 1750043568
  NPD (past)
• John Paul Rodgers, PHARMD

  • Pharmacist
  • St Petersburg, FL
  • NPI 1255814323
  NPD (past)
• Natassia Henna Tallmadge, PHARMD

  • Pharmacist
  • St Petersburg, FL
  • NPI 1497470140
  NPD (past)

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

{
    "created_epoch": "1245801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484870400000",
    "number": "1922236421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1839 CENTRAL AVE",
            "address_2": "U 101",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337138900",
            "telephone_number": "727-894-3001",
            "fax_number": "727-894-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1839 CENTRAL AVE",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337138900",
            "telephone_number": "727-894-3001",
            "fax_number": "727-894-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUTTA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-24",
        "last_updated": "2017-01-20",
        "status": "A",
        "authorized_official_last_name": "MALKAN",
        "authorized_official_first_name": "VISHAL",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "813-285-9365"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH24140",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2120787",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001304900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HEALTHMED PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Joseph Mathew Durgin, LCSW
• Stephanie Durocher, DC
• Leo J. Durrett Jr., D.D.S., P.A.
• Julia Durso, PMHNP
• Madison Marie Duschek
• Amanda Duvall, MD
• Danielle Alexandra Duvoisin, NP
• Jenna Duzs, GENETIC COUNSELOR
• Dva Renal Healthcare Inc (St. Petersburg Dialysis)
• Dva Renal Healthcare, Inc. (St. Petersburg South Dialysis)

• Community/Retail Pharmacy in St Petersburg, FL
• Providers in St Petersburg, 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 Jan 20, 2017; 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.