SHIVOAM LLC (NPI# 1134194202) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134194202 |
| Entity Type | Organization |
| Organization Name | SHIVOAM LLC |
| Other Organization Name | MEDICINE SHOPPE DELAND |
| Practice Address |
319 S Woodland Blvd Deland FL 32720 |
| Practice Telephone | 3867343383 |
| Practice Fax Number | 3867343384 |
| Mailing Telephone | 3867343383 |
| Mailing Fax Number | 3867343384 |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2020-05-22 |
| Authorized Official Name | HARDIK G SHAH (OWNER) |
| Authorized Official Telephone | 3522725944 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | PH11083 | FL | Suppliers |
| N | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
PH11083 | FL | Suppliers |
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
PH11083 | FL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER-COMMERCIAL NUMBER | 1064512 | 01 | |
| FL | DEA | BT2212304 | 01 |
| FL | 109020800 | 05 |
| Other Name | Type Code |
|---|---|
| Angel's Pharmacy | Doing Business As Name - Organization |
| MEDICINE SHOPPE DELAND | Doing Business As Name - Organization |
| Street Address |
319 S WOODLAND BLVD |
| City | DELAND |
| State | FL |
| Zip Code | 32720 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639144413 | Jack O'neil Lay | Pharmacist | 319 S Woodland Blvd, Deland, FL 32720-5853 | 2006-02-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679171532 | Kimberlee C Del Campo | Nurse Practitioner | 1590 S, State Highway 15a, Deland, FL 32720 | 2020-10-13 |
| 1699304840 | Grace Haven LLC | In Home Supportive Care | 805 S Stone St, Deland, FL 32720 | 2020-04-08 |
| 1609407766 | Michelle Rene' Tutt | Nurse Practitioner | 1590 South State Hwy 15a, Deland, FL 32720 | 2020-01-28 |
| 1902448715 | Volusia Medical Center LLC | Family Medicine | 850 N. Stone Street, Deland, FL 32720 | 2019-10-14 |
| 1548748957 | Christopher Lee Paik | Internal Medicine | 107 N Stone St, St A, Deland, FL 32720 | 2018-07-30 |
| 1164961041 | Melissa Sorensen | Counselor | 970 N Spring Ave, 523, Deland, FL 32720 | 2017-02-13 |
| 1669910329 | Stefanie Briann Yockey | Counselor | 804 N. Woodland Blvd., Deland, FL 32720 | 2017-02-02 |
| 1144648809 | Steven Shinn | Internal Medicine | 1590 S Sr 15a Ste 100, Deland, FL 32720 | 2014-03-31 |
| 1164843710 | Malgorzata Anna Szelwach | Occupational Therapist | 1590 State Rt 15a Suite B, Deland, FL 32720 | 2013-12-29 |
| 1730510926 | Adriana Marquez | Community/Behavioral Health | 33218 Tomahawk Trail, Deland, FL 32720 | 2013-12-12 |
| Find all providers in zip 32720 | ||||
| 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 |
|---|---|---|---|---|
| 1720506967 | Wal-mart Stores East Lp | Pharmacy | 955 S Woodland Blvd, Deland, FL 32720-0000 | 2017-09-08 |
| 1710427869 | Shivvinayak Inc | Pharmacy | 251 N Amelia Ave, Deland, FL 32724-4321 | 2017-03-07 |
| 1134223118 | Holiday Cvs LLC | Pharmacy | 901 N Woodland Blvd, Deland, FL 32720-2734 | 2006-09-12 |
| 1457455370 | Holiday Cvs LLC | Pharmacy | 2497 S Woodland Blvd, Deland, FL 32720-8637 | 2006-09-12 |
| 1063903672 | Northeast Florida Health Services Inc | Pharmacy | 1205 S Woodland Blvd Ste 5, Deland, FL 32720-7464 | 2018-05-21 |
| 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 | ||||
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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.