DEPARTMENT OF CHILDREN & FAMILES (NPI# 1629227442) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629227442 |
| Entity Type | Organization |
| Organization Name | DEPARTMENT OF CHILDREN & FAMILES |
| Other Organization Name | NORTHEAST FLORIDA STATE HOSPITAL PHARMACY |
| Practice Address |
7487 S State Road 121 Macclenny FL 32063-5451 |
| Practice Telephone | 9042596211 |
| Practice Fax Number | 9042596709 |
| Mailing Telephone | 9042596211 |
| Mailing Fax Number | 9042596709 |
| Enumeration Date | 2008-09-17 |
| Last Update Date | 2019-07-30 |
| Authorized Official Name | DR. TAN H PHAM (PHARMACY MANAGER) |
| Authorized Official Telephone | 9043302011 |
| Authorized Official Credential | PHARM.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 026002900 | 05 |
| Other Name | Type Code |
|---|---|
| Northeast Florida State Hospital Pharmacy | Doing Business As Name - Organization |
| Street Address |
7487 S STATE ROAD 121 |
| City | MACCLENNY |
| State | FL |
| Zip Code | 32063-5451 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538108410 | Muhammad Asghar Ali Shah | Psychiatry & Neurology | 7487 S State Road 121, Macclenny, FL 32063-5451 | 2006-06-06 |
| 1073126140 | Felix Alexander Soleh | Nurse Practitioner | 7487 S State Road 121, Macclenny, FL 32063-5480 | 2020-08-28 |
| 1275152480 | Amy Michelle Harvey | Nurse Practitioner | 7487 S State Road 121, Macclenny, FL 32063-5451 | 2020-04-09 |
| 1033625991 | Dustin Williams | Nurse Practitioner | 7487 S State Road 121, Macclenny, FL 32063-5451 | 2017-12-14 |
| 1144605148 | Merredith Oakes | Nurse Practitioner | 7487 S State Road 121, Macclenny, FL 32063-5451 | 2015-07-21 |
| 1578987764 | Amanda Nicole Simmons | Psychologist | 7487 S State Road 121, Macclenny, FL 32063-5451 | 2014-02-10 |
| 1811242514 | Olga Ines Arias | Psychiatry & Neurology | 7487 S State Road 121, Macclenny, FL 32063-5451 | 2012-07-18 |
| 1427358787 | Aron Croslin Bell | Counselor | 7487 S State Road 121, Macclenny, FL 32063-5451 | 2010-11-02 |
| 1538329719 | Toribio M Duhaylungsod | Psychiatry & Neurology | 7487 S State Road 121, Macclenny, FL 32063-5451 | 2008-06-11 |
| 1417126699 | Lara Miriam Greenwald | Dentist | 7487 S State Road 121, Macclenny, FL 32063-5451 | 2008-02-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578164976 | Justin Gary Dugger | Pharmacist | 9218 Sr-228 E, Macclenny, FL 32063 | 2020-11-03 |
| 1285175091 | Katie Rourke | Massage Therapist | 6068 -1 Larimer Rd, Macclenny, FL 32063 | 2017-03-13 |
| 1174734073 | Jane Ellen Echterling | Psychologist | Northeast Florida State Hospital, 7487 S. State Road 121, Macclenny, FL 32063 | 2007-05-24 |
| 1992879886 | Baker County Schools | Local Education Agency (LEA) | 290 Jonathan St E, Macclenny, FL 32063 | 2006-11-20 |
| 1306918271 | Baker County School Board | Local Education Agency (LEA) | 290 Jonathan Street East, Macclenny, FL 32063 | 2006-11-15 |
| 1780760967 | Patricia Ann Sova | Pharmacist | 1436 Sw 6th St, Winn Dixie #0144, Macclenny, FL 32063 | 2006-10-31 |
| 1447347992 | Annie Clara Widemond | Pharmacy Technician | 1436 State Road 121 South, Macclenny, FL 32063 | 2006-10-06 |
| 1003900713 | Luna S. Iskander | Psychiatry & Neurology | 7487 South State Road 121, Macclenny, FL 32063 | 2006-10-03 |
| 1558456103 | Cam Hoang | Family Medicine | 7487 South State Road 171, Macclenny, FL 32063 | 2006-10-03 |
| 1245323492 | Raynors Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 698 F W Macclenny Ave, Ste F, Macclenny, FL 32063 | 2006-10-02 |
| Find all providers in zip 32063 | ||||
| Taxonomy Code | 3336L0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Long Term Care Pharmacy |
| A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities for mentally retarded, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. |
| 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 |
|---|---|---|---|---|
| 1598362519 | Fast & Friendly Ltc Pharmacy, LLC | Pharmacy | 3202 W Baker St, Plant City, FL 33563-2849 | 2020-10-02 |
| 1326656265 | Sky City Pharmacy LLC | Pharmacy | 2812 W. Dr Martin Luther King Jr Blvd, Tampa, FL 33607 | 2020-07-16 |
| 1316565146 | Rx Care 17 LLC | Pharmacy | 7142 N. University Drive, Tamarac, FL 33321 | 2020-07-08 |
| 1891318689 | Aviva Care Pharmacy LLC | Pharmacy | 2053 North University Drive, Sunrise, FL 33322 | 2020-05-27 |
| 1811526650 | Careone Pharmacy Services LLC | Pharmacy | 1455 E Airport Blvd, Sanford, FL 32773-6818 | 2020-04-03 |
| 1982239810 | Wamu LLC | Pharmacy | 85 Cypress Point Pkwy Unit C, Palm Coast, FL 32164-8455 | 2020-03-11 |
| 1477186724 | Central Tampa Pharmacy LLC | Pharmacy | 5010 N 40th St Ste 201, Tampa, FL 33610-5202 | 2020-02-14 |
| 1790317311 | Specialty Rx Fl, LLC | Pharmacy | 15461 Sw 12th St Ste 108, Sunrise, FL 33326-1996 | 2020-02-11 |
| 1700426970 | Shambhu Inc. | Pharmacy | 19214 Nw Us Highway 441 Ste 10, High Springs, FL 32643-8783 | 2020-01-15 |
| 1205475175 | Lordoni Discount Pharmacy Inc | Pharmacy | 6300 N Wickham Rd Ste 126, Melbourne, FL 32940-2037 | 2019-12-24 |
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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.