NPIMap

Organization Active NPI

Treasure Coast Community Health Inc

  • Clinic Pharmacy
  • Fellsmere, FL
National Provider Identifier
1992003099
Registry record updated Mar 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic PharmacyTaxonomy code 3336C0002X
License
PH25316 Issued in FL
Legal business name
TREASURE COAST COMMUNITY HEALTH INC
Practice address
12196 County Road 512
Fellsmere, FL 32948-5463
Phone
(772) 257-8224
Fax
(772) 213-3157
NPI assigned
Mar 14, 2011
Organization subpart
Yes
Parent organization
TREASURE COAST COMMUNITY HEALTH, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 22, 2022

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

Authorized official

Name
Vicki Soule
Title
Ceo
Phone
(772) 257-8224

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Clinic Pharmacy 3336C0002X PH25316 FL Primary

Addresses

Primary practice location

12196 County Road 512
Fellsmere, FL 32948-5463

Mailing address

1555 Indian River Blvd Ste B210
Vero Beach, FL 32960-7113
Phone (772) 257-8224

Other identifiers 2

IdentifierTypeStateIssuer
003451200MedicaidFL
2129726OtherPK

Other names 1

  • Treasure Coast Community Health, Inc. Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Fellsmere Community Health24 organizations share this tax ID, including this one
Part of
Fellsmere Community Health

Other organizations with this tax ID 23

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

View all 23

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 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)…

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1300060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647907200000",
    "number": "1992003099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 INDIAN RIVER BLVD STE B210",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329607113",
            "telephone_number": "772-257-8224",
            "fax_number": "772-213-3157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12196 COUNTY ROAD 512",
            "city": "FELLSMERE",
            "state": "FL",
            "postal_code": "329485463",
            "telephone_number": "772-257-8224",
            "fax_number": "772-213-3157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TREASURE COAST COMMUNITY HEALTH INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TREASURE COAST COMMUNITY HEALTH, INC.",
        "enumeration_date": "2011-03-14",
        "last_updated": "2022-03-22",
        "certification_date": "2022-03-22",
        "status": "A",
        "authorized_official_last_name": "SOULE",
        "authorized_official_first_name": "VICKI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "772-257-8224"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "FL",
            "license": "PH25316",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003451200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2129726",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Treasure Coast Community Health, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fellsmere, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2022; 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.