Organization Active NPI

Rose Bros Inc

  • Community/Retail Pharmacy
  • Plantation, FL
National Provider Identifier
1992833867
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PH7015 Issued in FL
Legal business name
ROSE BROS INC
Practice address
100 NW 82ND Ave Ste 406
Plantation, FL 33324-1835
Phone
(954) 472-7244
Fax
(954) 472-7278
NPI assigned
Mar 1, 2007
Organization subpart
Yes
Parent organization
ROSE BROS INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Mr. Saji Samuel
Title
President
Phone
(954) 472-7244

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PH7015 FL Primary

Addresses

Primary practice location

100 NW 82ND Ave Ste 406
Plantation, FL 33324-1835

Mailing address

100 NW 82ND Ave
Suite 406
Plantation, FL 33324-7809
Phone (954) 472-7244

Other identifiers 1

IdentifierTypeStateIssuer
PH 7015OtherFLPHARMACY LICENSE

Other names 1

  • Medwise Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211201000654 FL Part B Supplier - Pharmacy 6507256831 Practice locations: Plantation, FL

National Provider Directory

National Provider Directory
Tax ID family
Rose Bros Inc2 organizations share this tax ID, including this one
Part of
Rose Bros Inc

Other organizations with this tax ID 1

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

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)
  • HealthSun Health Plans Network
  • 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)…

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

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": "1172707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1992833867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 NW 82ND AVE",
            "address_2": "SUITE 406",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333247809",
            "telephone_number": "954-472-7244",
            "fax_number": "954-472-7278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NW 82ND AVE STE 406",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333241835",
            "telephone_number": "954-472-7244",
            "fax_number": "954-472-7278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSE BROS INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ROSE BROS INC",
        "enumeration_date": "2007-03-01",
        "last_updated": "2023-03-07",
        "certification_date": "2023-01-10",
        "status": "A",
        "authorized_official_last_name": "SAMUEL",
        "authorized_official_first_name": "SAJI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-472-7244",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH7015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY LICENSE",
            "identifier": "PH 7015",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medwise Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Plantation, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.