Ridge Manor Pharmacy

Primary specialty

PharmacyTaxonomy code 333600000X

License

PH30189 Issued in FL

Legal business name

RIDGE MANOR PHARMACY

Doing business as

Benzer Pharmacy Ridge Manor

Practice address

34490 Cortez Blvd
Ridge Manor, FL 33523-8908

Phone

(352) 437-6851

Fax

(352) 437-6852

NPI assigned

Jul 12, 2016

Organization subpart

No

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

Authorized official

Name

Basim Ahmed

Title

Owner

Phone

(352) 681-1988

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Benzer Pharmacy Ridge Manor Doing business as

Locations

Networks

• 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)
• 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)…

Practitioners 1

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.

• Tejal Shah

  • Pharmacist
  • Allen, TX
  • NPI 1396275939
  NPD (past)

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

{
    "created_epoch": "1468281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484697600000",
    "number": "1922450196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9603 ORANGE JASMINE WAY",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336473020",
            "telephone_number": "813-304-2221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34490 CORTEZ BLVD",
            "city": "RIDGE MANOR",
            "state": "FL",
            "postal_code": "335238908",
            "telephone_number": "352-437-6851",
            "fax_number": "352-437-6852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIDGE MANOR PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-12",
        "last_updated": "2017-01-18",
        "status": "A",
        "authorized_official_last_name": "AHMED",
        "authorized_official_first_name": "BASIM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "352-681-1988"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "FL",
            "license": "PH30189",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "018722900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2160561",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Benzer Pharmacy Ridge Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kerry Hernandez
• Joseph Janiczek, LMT
• Brittany Maria Johnson, M.S. ITDS
• Juan Pablo Lopez Gonzalez, MD
• Thomas Ostrander II, LPN
• Nikki Jane Riegel, FNP-C
• Ana Maria Rodriguezperez
• Sunridge Ministries, Inc

• Pharmacy in Ridge Manor, FL
• Providers in Ridge Manor, FL by specialty
• Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 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.