CRESTVIEW PHARMACY, LLC (NPI# 1407965262) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407965262 |
| Entity Type | Organization |
| Organization Name | CRESTVIEW PHARMACY, LLC |
| Other Organization Name | CRESTVIEW PHARMACY, INC |
| Practice Address |
1116 N Ferdon Blvd Crestview FL 32536-1710 |
| Practice Telephone | 8506831111 |
| Practice Fax Number | 8506831753 |
| Mailing Telephone | 8506831111 |
| Mailing Fax Number | 8506831753 |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2019-06-11 |
| Authorized Official Name | MR. VINCE DAGRAVA (COO) |
| Authorized Official Telephone | 8595525013 |
| Authorized Official Credential | PHARMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
PH18397 | FL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 025327800 | 05 | |
| FL | NCPDP - NAPB | 1094870 | 01 |
| AL | 100200027 | 05 |
| Other Name | Type Code |
|---|---|
| Crestview Pharmacy, Inc | Former Legal Business Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184744344 | Crestview Pharmacy, LLC | Pharmacy | 7100 Woodrow Ave, Austin, TX 78757-1802 | 2007-03-30 |
| Street Address |
1116 N FERDON BLVD |
| City | CRESTVIEW |
| State | FL |
| Zip Code | 32536-1710 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487663803 | Hal J. Densman | Pharmacist | 1116 N Ferdon Blvd, Crestview, FL 32536-1710 | 2006-08-05 |
| 1699321331 | Jennifer Reshay Wood | Pharmacist | 1116 N Ferdon Blvd, Crestview, FL 32536-1710 | 2019-08-16 |
| 1255987996 | Emily Claire Blackmon | Pharmacist | 1116 N Ferdon Blvd, Crestview, FL 32536-1710 | 2019-08-16 |
| 1932442225 | Heather Cooley | Pharmacist | 1116 N Ferdon Blvd, Crestview, FL 32536-1710 | 2013-04-04 |
| 1346581030 | Melvin Douglas Livingston Jr. | Pharmacist | 1116 N Ferdon Blvd, Crestview, FL 32536-1710 | 2013-03-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831684901 | Eva Maria I Matute | Adult Companion | 6050 Trestle St, Crestview, FL 32536 | 2018-06-29 |
| 1669989232 | Lauren Estep Flowers | Physician Assistant | 550 Redstone Ave W Ste 370, Crestview, FL 32536 | 2018-01-04 |
| 1427444868 | Jessie Huisken | Social Worker | 5890 Saratoga Dr, Crestview, FL 32536 | 2015-04-13 |
| 1679846166 | John D. Carlson Md | Specialist | 492 North Wilson Street, Crestview, FL 32536 | 2012-02-15 |
| 1154609691 | Alternative Living, Inc. | Assisted Living Facility | 603 North Pearl Street, Crestview, FL 32536 | 2011-08-02 |
| 1487821526 | Michael G Foley Md Pa | Internal Medicine | 524 James Lee Blvd W, Crestview, FL 32536 | 2008-05-08 |
| 1184805830 | Advanced Family Medicine Clinic Inc | Family Medicine | 327 Medcrest Drive, Unit A, Crestview, FL 32536 | 2007-11-23 |
| 1164631511 | Caring Hearts Pediatric Extended Care Center, Inc | Clinic/Center | 380 Medcrest Dr, Crestview, FL 32536 | 2007-05-22 |
| 1669697751 | Crestview Chiropractic Clinic, Inc. | Chiropractor | 1078 S. Ferdon Boulevard, Suite A, Crestview, FL 32536 | 2007-04-16 |
| 1457492886 | Roy M Nakaiye | Dentist | 222 Cedar Ave, Crestview, FL 32536 | 2007-02-09 |
| Find all providers in zip 32536 | ||||
| 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 |
|---|---|---|---|---|
| 1780789941 | Moulton's Pharmacy, Inc. | Pharmacy | 648 N Ferdon Blvd, Crestview, FL 32536-2165 | 2006-09-13 |
| 1841244316 | Garrett's Pharmacy Services, Inc. | Pharmacy | 536 E 1st Ave, Crestview, FL 32536-2505 | 2006-05-20 |
| 1871947499 | Moulton's Pharmacy of Crestview, Inc. | Pharmacy | 648 N Ferdon Blvd, Crestview, FL 32536-2165 | 2016-04-20 |
| 1043313794 | Holiday Cvs LLC | Pharmacy | 302 E James Lee Blvd, Crestview, FL 32539-2827 | 2006-09-07 |
| 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.