PALM COAST PHARMACY INC NPI 1962637496

NPI Information

NPI: 1962637496
Provider Name: PALM COAST PHARMACY INC
Classification: Pharmacy - 3336L0003X
Entity Type: Organization

Specialization: Long Term Care Pharmacy

Address:
9 PINE CONE DR
SUITE 109
PALM COAST, FL
ZIP 32137
Phone: (386) 597-7400
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PALM COAST PHARMACY INC is a long term care pharmacy pharmacy in Palm Coast, FL. The provider is a pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. PALM COAST PHARMACY INC NPI is 1962637496. The provider is registered as an organization entity type.

The provider's business location address is:

9 PINE CONE DR
SUITE 109
PALM COAST, FL
ZIP 32137-686
Phone: (386) 597-7400
Fax: (386) 246-7515

The provider's authorized official is Valeriy Krayter .
The authorized official title is President and has the following contact phone number (386) 597-7400.

The enumeration date for this NPI number is 5/28/2009 and was last updated on 3/7/2023.

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	332B00000X	Durable Medical Equipment & Medical Supplies				No
2	3336C0003X	Pharmacy	Community/Retail Pharmacy	PH24188	FLORIDA	No
3	3336L0003X	Pharmacy	Long Term Care Pharmacy			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	001391500	MEDICAID	FLORIDA

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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