NORTHLAKE PHARMACY LLC (NPI# 1053762260) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053762260 |
| Entity Type | Organization |
| Organization Name | NORTHLAKE PHARMACY LLC |
| Other Organization Name | NORTHLAKE PHARMACY |
| Practice Address |
9091 N Military Trl Ste 17 Palm Beach Gardens FL 33410-5983 |
| Practice Telephone | 5616199900 |
| Practice Fax Number | 5616199902 |
| Mailing Telephone | 5616199900 |
| Mailing Fax Number | 5616199902 |
| Enumeration Date | 2016-06-29 |
| Last Update Date | 2017-03-14 |
| Authorized Official Name | SALIM SOUFAN (OWNER/PHARMACIST/AO) |
| Authorized Official Telephone | 5615622610 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
PH30206 | FL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2160865 | 01 | |
| FL | 018799700 | 05 |
| Other Name | Type Code |
|---|---|
| Northlake Pharmacy | Doing Business As Name - Organization |
| Street Address |
9091 N MILITARY TRL STE 17 |
| City | PALM BEACH GARDENS |
| State | FL |
| Zip Code | 33410-5983 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811501026 | Vicky Pauline Salazar | Registered Nurse | 11501 N Military Trail, Palm Beach Gardens, FL 33410 | 2020-09-04 |
| 1417596388 | Chavon E Mayer | Doula | 149 Winter Park Lane, West Palm Beach, FL 33410 | 2019-12-24 |
| 1639711617 | Diamond Physical Therapy, LLC | Physical Therapist | 4025 Johnson Dairy Road, Palm Beach Gardens, FL 33410 | 2019-10-11 |
| 1689151714 | Caroline Devries Hesterman | Occupational Therapist | 9840 Alternate A1a Ste 402, Palm Beach Gardens, FL 33410 | 2018-07-21 |
| 1366937088 | Krystal Maya Khemkaran | Behavior Technician | 2979 Pga Blvd # 200, Palm Beach Gardens, FL 33410 | 2018-06-25 |
| 1548762552 | Arsenia Pomperada Sabusap | Nurse Practitioner | Grace Medical Center of Florida, 4212 Northlake Blvd., Palm Beach Gardens, FL 33410 | 2018-03-06 |
| 1538668199 | Alan Seidenfeld | Dentist | 7305 N Military Trl 3a-200, Riviera Beach, FL 33410 | 2018-02-08 |
| 1407361454 | Nuvista Living At Jupiter, LLC | Skilled Nursing Facility | 338 Pioneer Road, Jupiter, FL 33410 | 2017-12-12 |
| 1083125728 | Tom Long Biddle-xing | Nurse Practitioner | 3345 Burns Rd Ste 206, Palm Beach Gardens, FL 33410 | 2017-10-20 |
| 1801315189 | Kasie Sidman | Physical Therapist | 3929 Bluebell St, Palm Beach Gardens, FL 33410 | 2017-09-18 |
| Find all providers in zip 33410 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851602205 | Prescriptions By Mail LLC | Pharmacy | 3579 Northlake Blvd, Palm Beach Gardens, FL 33403-1625 | 2010-06-30 |
| 1154553659 | Walgreen Co. | Pharmacy | 4860 Donald Ross Rd, Palm Beach Gardens, FL 33418-7201 | 2009-08-17 |
| 1609032259 | Premier Compounding Pharmacy Inc | Pharmacy | 2000 Pga Blvd Ste 5507, Ste 5507, Palm Beach Gardens, FL 33408-2726 | 2008-08-04 |
| 1215034707 | Holiday Cvs LLC | Pharmacy | 9830 Hwy A1a, Palm Beach Gardens, FL 33410 | 2006-09-19 |
| 1285739011 | Holiday Cvs LLC | Pharmacy | 3168 Nlake Blvd, Palm Beach Gardens, FL 33403 | 2006-09-14 |
| 1518061472 | Holiday Cvs LLC | Pharmacy | 2480 Pga Blvd, Palm Beach Gardens, FL 33410-3507 | 2006-09-12 |
| 1790889764 | Holiday Cvs LLC | Pharmacy | 11586 Us Highway 1, Palm Beach Gardens, FL 33408-3019 | 2006-09-12 |
| 1184734790 | Costco Wholesale Corporation | Pharmacy | 3250 Northlake Blvd, Palm Beach Gardens, FL 33403 | 2006-08-30 |
| 1225049448 | Holiday Cvs, L.L.C. | Pharmacy | 4500 Donald Ross Road, Palm Beach Gardens, FL 33418 | 2006-08-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649871583 | Florida Community Health Centers, Inc. | Pharmacy | 9576 S Us Highway 1, Port Saint Lucie, FL 34952-4217 | 2020-11-06 |
| 1053911883 | Nrc Pharmd Inc | Pharmacy | 2700 Immokalee Rd Ste 24, Naples, FL 34110-1437 | 2020-10-30 |
| 1073112116 | Hl72 LLC | Pharmacy | 5193 Clark Rd, Sarasota, FL 34233-3213 | 2020-10-20 |
| 1689280851 | Unique Pharmacy Corp | Pharmacy | 7800 Sw 87th Ave Ste 210b, Miami, FL 33173-2537 | 2020-09-22 |
| 1033723127 | Five Pillars Corporation | Pharmacy | 2301 N University Dr Ste 112, Pembroke Pines, FL 33024-3617 | 2020-09-04 |
| 1780297655 | Healthy Living Pharmacy LLC | Pharmacy | 755 Rosemary Cir, Bradenton, FL 34212-5015 | 2020-08-28 |
| 1326651555 | Purformance Wellness Pharmacy LLC | Pharmacy | 600 Se Indian St Ste 3, Stuart, FL 34997-5540 | 2020-08-27 |
| 1043822620 | Specialtycarerx LLC | Pharmacy | 821 N Us Highway 1 Ste A, Ormond Beach, FL 32174-4528 | 2020-08-17 |
| 1831700855 | Kingsley Rx LLC | Pharmacy | 1542 Kingsley Ave Ste 142, Orange Park, FL 32073-4547 | 2020-08-13 |
| 1104435742 | Easyscripts LLC | Pharmacy | 2601 S Military Trl Ste 1, West Palm Beach, FL 33415-7509 | 2020-07-29 |
| Find all providers with the same taxonomy | ||||
| City | PALM BEACH GARDENS |
| Zip Code | 33410 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.