Village Pharmacy of Nokomis LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PH21919 Issued in FL

Legal business name

VILLAGE PHARMACY OF NOKOMIS LLC

Doing business as

Village Pharmacy

Practice address

1095 Tamiami TRL N
Ste B
Nokomis, FL 34275-2114

Phone

(941) 488-8800

Fax

(941) 488-8802

NPI assigned

May 23, 2006

Organization subpart

No

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

Authorized official

Name

Jeffrey Young, R.PH.NPI 1043784291

Title

MGR

Phone

(941) 488-8800

Specialties & licenses 5

Addresses

Other identifiers 1

Other names 1

• VILLAGE PHARMACY Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeffrey E Young, RPH

  • Pharmacist
  • Nokomis, FL
  • NPI 1043784291
  NPD Authorized official
• Robert Weltig, RPH

  • Pharmacist
  • Venice, FL
  • NPI 1851855977
  NPD (past)

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573603200000",
    "number": "1962457796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1095 TAMIAMI TRL N",
            "address_2": "STE B",
            "city": "NOKOMIS",
            "state": "FL",
            "postal_code": "342752114",
            "telephone_number": "941-488-8800",
            "fax_number": "941-488-8802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1095 TAMIAMI TRL N",
            "address_2": "STE B",
            "city": "NOKOMIS",
            "state": "FL",
            "postal_code": "342752114",
            "telephone_number": "941-488-8800",
            "fax_number": "941-488-8802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE PHARMACY OF NOKOMIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-23",
        "last_updated": "2019-11-13",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "MGR",
        "authorized_official_telephone_number": "941-488-8800",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH21919",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2006650",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VILLAGE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "VILLAGE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Elizabeth Townsend
• Samantha Trebisacci, PHARMD
• Olga Ulitsky
• Lynn Ann Vanstone, CCC-SLP
• Audrey Lynn Vero, MS, RD
• VMD Primary Providers Central Florida PLLC
• Ember Lee Charlotte Wackelin
• Walgreen Co (Walgreens #11787)
• Anthony Warner, RCSWI
• Justin Ross Wasserman, MD

• Community/Retail Pharmacy in Nokomis, FL
• Providers in Nokomis, 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 Nov 13, 2019; 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.