NPIMap

Collier Health Services Inc.

Organization Active NPI Community/Retail Pharmacy · Naples, FL

NPI 1962951996 · NPPES record last updated Apr 27, 2020

Key facts

NPI
1962951996
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
License
PH30347 (FL)
Legal business name
COLLIER HEALTH SERVICES INC.
Practice address
12655 Collier Blvd
Naples, FL 34116-4005
Phone
(239) 658-3000
NPI assigned
Oct 3, 2016
Organization subpart
No

Authorized official

Name
Tami Raznoff
Title
Cfo
Phone
(239) 658-3707

Other NPIs with the same Medicare PAC ID 24

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 16

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 29

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

View all 29

Medicare participation

Medicare fee-for-service enrollment
Enrolled in FL

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20171024001355 FL DME Supplier - Pharmacy 4183521925 Practice locations: Naples, FL

National Provider Directory

Tax ID family
Collier Health Services Central Naples Pediatrics (79 organizations share this tax ID)

Networks

  • Freedom Health HMO Network
    Plans: 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 Maximo (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 Network
    Plans: 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)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PH30347 FL Yes

Addresses

Primary practice location

12655 Collier Blvd
Naples, FL 34116-4005

Mailing address

1454 Madison Ave W
Immokalee, FL 34142-2200
Phone (239) 658-3000

Other practice location 1

1755 Heritage Trl
suite 604
Naples, FL 34112-7600
Phone (239) 658-3000 ext. 3772

Other names

  • HealthCare Network of Southwest Florida Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 27, 2020.

{
    "created_epoch": "1475452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587945600000",
    "number": "1962951996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1454 MADISON AVE W",
            "city": "IMMOKALEE",
            "state": "FL",
            "postal_code": "341422200",
            "telephone_number": "239-658-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12655 COLLIER BLVD",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341164005",
            "telephone_number": "239-658-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1755 Heritage Trl",
            "address_2": "suite 604",
            "address_purpose": "LOCATION",
            "city": "Naples",
            "state": "FL",
            "postal_code": "341127600",
            "country_code": "US",
            "telephone_number": "239-658-3000 x3772",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COLLIER HEALTH SERVICES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-03",
        "last_updated": "2020-04-27",
        "certification_date": "2020-04-27",
        "status": "A",
        "authorized_official_last_name": "RAZNOFF",
        "authorized_official_first_name": "TAMI",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "239-658-3707"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH30347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HealthCare Network of Southwest Florida",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "HealthCare Network of Southwest Florida",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Naples, FL

All providers in Naples, FL · Community/Retail Pharmacy in Florida

Sources for this page

Verify at the official NPI Registry.