Active NPI
The Watts Co of Marianna Inc
- Community/Retail Pharmacy
- Marianna, FL
National Provider Identifier
1972601904
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- Legal business name
- THE WATTS CO OF MARIANNA INC
- Practice address
- 4154 Lafayette St Ste G
St G
Marianna, FL 32446-5655 - Phone
- (850) 482-5781
- Fax
- (850) 482-6880
- NPI assigned
- Sep 21, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jim Watts
- Title
- President
- Phone
- (850) 482-5781
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | PH3054 | FL | |
| Community/Retail Pharmacy | 3336C0003X | Primary |
Addresses
Primary practice location
4154 Lafayette St Ste G
St G
Marianna, FL 32446-5655
Mailing address
4154 Lafayette St Ste G
St G
Marianna, FL 32446-5655
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1014391 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER | |
| 101755100 | Medicaid | FL |
Other names 1
- WACO DRUGS AND GIFTS
National Provider Directory
National Provider DirectoryLocations
4154 Lafayette St
Ste G
Marianna, FL 32446
Phone (850) 482-5781
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158796800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1282608000000",
"number": "1972601904",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4154 LAFAYETTE ST STE G",
"address_2": "ST G",
"city": "MARIANNA",
"state": "FL",
"postal_code": "324465655"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4154 LAFAYETTE ST STE G",
"address_2": "ST G",
"city": "MARIANNA",
"state": "FL",
"postal_code": "324465655",
"telephone_number": "850-482-5781",
"fax_number": "850-482-6880"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "THE WATTS CO OF MARIANNA INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-21",
"last_updated": "2010-08-24",
"status": "A",
"authorized_official_last_name": "WATTS",
"authorized_official_first_name": "JIM",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "850-482-5781"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "FL",
"license": "PH3054",
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
"identifier": "1014391",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "101755100",
"state": "FL"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "WACO DRUGS AND GIFTS",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Marianna, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.