Port St John Discount Pharmacy
LBN: Brevard Pharmacy Llc
Port St John Discount Pharmacy is an health care organization with primary practice located at 6250 N Us Highway 1 , Cocoa FL 32927-4926. The organization recently has 5 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy, Suppliers / Long Term Care Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Brevard Pharmacy Llc can be contacted via phone (321) 305-6975, or through Patel, Rajesh via phone (407) 488-6851.
Contact Information
Primary practice address
6250 N Us Highway 1
Cocoa FL 32927-4926
Phone: (321) 305-6975
Fax: (321) 305-6978
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X | ||
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | PH30509 | Florida |
| Suppliers / Compounding Pharmacy | 3336C0004X | ||
| Suppliers / Long Term Care Pharmacy | 3336L0003X |
Profile Details
| NPI number | 1316488281 |
|---|---|
| LBN Legal business name | Brevard Pharmacy Llc |
| DBA Doing business as | Port St John Discount Pharmacy |
| Authorized official | Patel, Rajesh |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Mar 13th, 2017 |
| Last updated | Mar 13th, 2017 - about 9 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1316488281 | NPPES |
| Florida | MEDICAID | 003226300 | |
| Florida | Other | 2168151 |
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