SEMINOLE PHARMACY (NPI# 1376072132) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376072132 |
| Entity Type | Organization |
| Organization Name | SEMINOLE PHARMACY |
| Other Organization Name | SEMINOLE PHARMACY |
| Practice Address |
31055 Josie Billie Highway Clewiston FL 33440 |
| Mailing Address |
30290 Josie Billie Hwy Clewiston FL 33440-9502 |
| Practice Telephone | 8639831197 |
| Practice Fax Number | 8639831214 |
| Mailing Telephone | (863) 983-1197 |
| Mailing Fax Number | 8639831214 |
| Enumeration Date | 2017-06-06 |
| Last Update Date | 2017-06-06 |
| Authorized Official Name | MONICA OBAN (PHARMACY PROGRAM MANAGER) |
| Authorized Official Telephone | 9549651331 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| N | 3336C0002X |
Pharmacy Specialization: Clinic Pharmacy |
Suppliers | ||
| Y | 332800000X | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2169622 | 01 |
| Other Name | Type Code |
|---|---|
| SEMINOLE PHARMACY | Doing Business As Name - Organization |
| Street Address |
31055 JOSIE BILLIE HIGHWAY |
| City | CLEWISTON |
| State | FL |
| Zip Code | 33440 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740551530 | Seminole Tribe of Florida | Clinic/Center | 30851 Buffalo Jim Loop Road, Clewiston, FL 33440 | 2012-01-25 |
| 1184850901 | Elizabeth Boykin | Nurse Practitioner | 31055 Josie Billie Hwy, Clewiston, FL 33440 | 2009-06-08 |
| 1861683237 | Antoinette Marie Pavey-mcdaniel | Nurse Practitioner | 203 S Gloria St, Hendry Regional Corp Health, Clewiston, FL 33440 | 2007-08-09 |
| 1225229909 | Kurt Gabriel Hausy | Dentist | 316 E. Trinidad Ave., Clewiston, FL 33440 | 2007-08-07 |
| 1265565527 | Joanne Louise Vorhees | Nurse Practitioner | 1100 South Olympia St, Hendry County Health Department, Clewiston, FL 33440 | 2007-03-14 |
| 1831222850 | Richard J Anton | Optometrist | 1005 W. Sugarland Hwy, Walmart Nat Vision Cen, Clewiston, FL 33440 | 2007-03-13 |
| 1932278017 | Eckerd Youth Alternatives Inc | Psychiatric Residential Treatment Facility | 28280 E Tu Makee Way, Clewiston, FL 33440 | 2006-11-06 |
| 1720342173 | Vandhana Bhagwan Kiswani-barley | Family Medicine | 31055 Josie Billie Hwy, Clewiston, FL 33440 | 2012-06-29 |
| 1275782492 | Juan and John Drugs | Pharmacy | 340 E Sugarland Hwy, Suite B, Clewiston, FL 33440 | 2008-09-11 |
| 1750916417 | Play The Ot Way LLC | Occupational Therapist | 812 Laurel St, Clewiston, FL 33440-2428 | 2020-03-03 |
| Find all providers in zip 33440 | ||||
| Taxonomy Code | 332800000X |
| Grouping | Suppliers |
| Classification | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy |
| An Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy means a pharmacy operated by the Indian Health Service, an Indian tribe or tribal organization, or an urban Indian organization, all of which are defined in Section 4 of the Indian Health Care Improvement Act, 25 U.S.C. 1603. |
| Notes: Source: The Medicare Prescription Drug, Improvement and Modernization Act of 2003 [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861842734 | Vital Life Institute, LLC | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 1618 Main St, Sarasota, FL 34236-5811 | 2016-06-21 |
| 1023320249 | Panama Drugs Inc | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 3127 E Highway 98, Panama City, FL 32401-5415 | 2010-07-02 |
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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.