ANNALICE LLC (NPI# 1083848865) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083848865 |
| Entity Type | Organization |
| Organization Name | ANNALICE LLC |
| Other Organization Name | PEGASUS RX PHARMACY |
| Practice Address |
115 W Belt Ave Bushnell FL 33513-5101 |
| Practice Telephone | 3527933100 |
| Practice Fax Number | 3527933106 |
| Mailing Telephone | 3527933100 |
| Mailing Fax Number | 3527933106 |
| Enumeration Date | 2009-05-08 |
| Last Update Date | 2017-03-01 |
| Authorized Official Name | NELSON OHIHOIN (CEO) |
| Authorized Official Telephone | 7275341318 |
| 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 |
PH24029 | FL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2120290 | 01 | |
| FL | 001215500 | 05 |
| Other Name | Type Code |
|---|---|
| Pegasus Rx Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629398003 | Annalice LLC | Pharmacy | 6506 Embassy Blvd, Port Richey, FL 34668-4734 | 2010-06-08 |
| 1649593179 | Annalice LLC | Pharmacy | 1992 Alt Us Highway 19, Tarpon Springs, FL 34689 | 2010-03-11 |
| Street Address |
115 W BELT AVE |
| City | BUSHNELL |
| State | FL |
| Zip Code | 33513-5101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619465481 | Crystal Wallace Goddin | Physical Therapy Assistant | 1104 N Main St, Bushnell, Fl, Bushnell, FL 33513 | 2018-04-27 |
| 1255836920 | Anton Dawson | Behavior Technician | 2310 Cr 615, Bushnell, FL 33513 | 2018-03-26 |
| 1942728431 | Carolyn Sue Guarino | Licensed Practical Nurse | 10306 S.w. 53rd Terr., Bushnell, FL 33513 | 2017-09-05 |
| 1326321258 | Edith Marie Evans | Case Manager/Care Coordinator | 2891 C.r. 615b, Bushnell, FL 33513 | 2011-09-27 |
| 1144478439 | Emma J Ridley | Pharmacist | Sumter Oaks Park, 4602 Couny Rd. 673, #14107, Bushnell, FL 33513 | 2008-08-29 |
| 1205083268 | Diana K Mullin | Day Training, Developmentally Disabled Services | 9325 Cr 622 G, Bushnell, FL 33513 | 2008-08-21 |
| 1467625202 | Amy's Caring Hands | Day Training, Developmentally Disabled Services | 1612 W County Road 476, Bushnell, FL 33513 | 2008-04-11 |
| 1821212952 | Stuart J Kaufman Md & Assoc Pa | Ophthalmology | 1814 West Cr 48, Bushnell, FL 33513 | 2007-04-12 |
| 1740201128 | Winn Dixie Stores Inc | Durable Medical Equipment & Medical Supplies | 1122 N Main St, Bushnell, FL 33513 | 2006-07-21 |
| 1184688947 | Florida Department of Health | Public Health or Welfare | 415 E Noble Ave, Bushnell, FL 33513 | 2006-04-17 |
| Find all providers in zip 33513 | ||||
| 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 |
|---|---|---|---|---|
| 1285738195 | Holiday Cvs LLC | Pharmacy | 420 N Main St, Bushnell, FL 33513-5427 | 2006-09-12 |
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| 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 | ||||
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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.