MAGELLAN RX PHARMACY LLC NPI 1245241884

NPI Information

NPI: 1245241884
Provider Name: MAGELLAN RX PHARMACY LLC

Doing Business As: MAGELLAN RX PHARMACY

Classification: Pharmacy - 3336S0011X
Entity Type: Organization

Specialization: Specialty Pharmacy

Address:
6870 SHADOWRIDGE DR
STE 111
ORLANDO, FL
ZIP 32812
Phone: (866) 554-2673
Get Directions

MAGELLAN RX PHARMACY LLC is a specialty pharmacy pharmacy in Orlando, FL. The provider is a pharmacy that dispenses generally low volume and high cost medicinal preparations to patients who are undergoing intensive therapies for illnesses that are generally chronic, complex and potentially life threatening. Often these therapies require specialized delivery and administration. MAGELLAN RX PHARMACY LLC NPI is 1245241884. The provider is registered as an organization entity type.
The provider Is Doing Business As Magellan Rx Pharmacy.

The provider's business location address is:

6870 SHADOWRIDGE DR
STE 111
ORLANDO, FL
ZIP 32812-002
Phone: (866) 554-2673
Fax: (866) 364-2673

The provider's authorized official is Kuo Wong .
The authorized official title is Vp Pharmacy Operations and has the following contact phone number (866) 554-2673.

The enumeration date for this NPI number is 8/10/2006 and was last updated on 3/14/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	333600000X	Pharmacy				No
2	3336S0011X	Pharmacy	Specialty Pharmacy	PH19541	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1245241884	MEDICAID	WISCONSIN
2	1245241884	MEDICAID	MAINE
3	1245241884	MEDICAID	WASHINGTON
4	10132338040002	MEDICAID	PENNSYLVANIA
5	2006243	OTHER		PK
6	1245241884	MEDICAID	OHIO
7	1245241884	MEDICAID	VIRGINIA
8	1245241884	MEDICAID	VERMONT
9	200855460A	MEDICAID	INDIANA
10	30708673	MEDICAID	NEW HAMPSHIRE
11	100265185-00	MEDICAID	NEBRASKA
12	1245241884	MEDICAID	MICHIGAN
13	1245241884	MEDICAID	MINNESOTA
14	513347297001	MEDICAID	ILLINOIS
15	538884	MEDICAID	NEW JERSEY
16	031904000	MEDICAID	FLORIDA
17	1612421	MEDICAID	ALASKA
18	200412310A	MEDICAID	OKLAHOMA
19	589259	MEDICAID	ARIZONA
20	ATN66122	MEDICAID	COLORADO
21	1245241884	MEDICAID	CONNECTICUT
22	1245241884	MEDICAID	IDAHO
23	415778800	MEDICAID	MARYLAND
24	54012687	MEDICAID	KENTUCKY
25	600200927	MEDICAID	MISSOURI
26	1528692	MEDICAID	TENNESSEE
27	7F9541	MEDICAID	SOUTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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