RADIANCE PHARMACY INC. (NPI# 1710985544) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710985544 |
| Entity Type | Organization |
| Organization Name | RADIANCE PHARMACY INC. |
| Other Organization Name | RADIANCE PHARMACY |
| Practice Address |
110 Clearwater Largo Rd S Largo FL 33770-3233 |
| Practice Telephone | 7275889878 |
| Practice Fax Number | 7275889858 |
| Mailing Telephone | 7275889878 |
| Mailing Fax Number | 7275889858 |
| Enumeration Date | 2005-07-14 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. NWANDO OBIANUJU NWANNA (PHARAMCIST/OWNER) |
| Authorized Official Telephone | 7275889878 |
| Authorized Official Credential | PHARM.D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
PH20948 | FL | Suppliers |
| X | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
PH20948 | FL | Suppliers |
| X | 332BD1200X |
Durable Medical Equipment & Medical Supplies Specialization: Dialysis Equipment & Supplies |
PH 20948 | FL | Suppliers |
| Other Name | Type Code |
|---|---|
| RADIANCE PHARMACY | Doing Business As Name - Organization |
| Street Address |
110 CLEARWATER LARGO RD S |
| City | LARGO |
| State | FL |
| Zip Code | 33770-3233 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467005041 | Chelsey Lyn Shepos | Optometrist | 1030 West Bay Dr, Suite 200, Largo, FL 33770 | 2019-07-22 |
| 1407353626 | Michael E Ibrahim | Pharmacist | 1290 West Bay Drive, Largo, FL 33770 | 2018-04-13 |
| 1518413384 | Payton Kuhlenbeck | Anesthesiology | 210 14th Street Sw, Largo, FL 33770 | 2016-08-31 |
| 1639536865 | Ryan Boice | Physical Therapy Assistant | 118 West Bay Drive, Suite 111, Largo, FL 33770 | 2016-01-19 |
| 1508238858 | Alignment Healthcare Florida LLC | Clinic/Center | 1301 2nd Ave., Sw, Largo, FL 33770 | 2015-10-27 |
| 1891161808 | Jessica Nicole Mcglone | Nurse Practitioner | 601 Rosery Rd Ne Apt 1502, Largo, FL 33770 | 2015-08-12 |
| 1033598602 | Demetria Anderson | Counselor | 1301 Seminole Blvd Ste 103, Largo, FL 33770 | 2015-05-28 |
| 1962881821 | Building Blocks Therapy, Pllc | Community/Behavioral Health | 1301 Seminole Blvd Building A Suite 103, Largo, FL 33770 | 2015-05-26 |
| 1457765968 | Summer Moon | Dermatology | 115 Highland Ave N, Largo, FL 33770 | 2014-06-12 |
| 1578982393 | Lauren Elizabeth Grandpre | Emergency Medicine | 201 14th St. Sw, Largo Medical Center Emergency Department, Largo, FL 33770 | 2014-04-09 |
| Find all providers in zip 33770 | ||||
| Taxonomy Code | 3336C0004X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Compounding Pharmacy |
| A pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner’s Prescription Drug Order or initiative based on the Practitioner/Patient/Pharmacist relationship in the course of professional practice. A compounding pharmacy utilizes specialized equipment and specially designed facilities necessary to meet the legal and quality requirements of its scope of compounding practice. |
| Notes: Sources: NABP Model Practice Act, Appendix C - Good Compounding Practice, USP <795> and <797>, and Pharmacy Compounding Accreditation Board [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245625821 | Sterile Compounding Pharmacy LLC. | Pharmacy | 7381 114th Ave, Suite 405a, Largo, FL 33773-5131 | 2015-04-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508473414 | Tu Te Wellness Pharmacy LLC | Pharmacy | 8563 Argyle Business Loop Ste 1, Jacksonville, FL 32244-6613 | 2020-09-24 |
| 1467068197 | Avm Compounding Pharmacy LLC | Pharmacy | 501 S Lincoln Ave Ste 203, Clearwater, FL 33756-5945 | 2020-09-18 |
| 1376151423 | 1st America Infusion Services LLC | Pharmacy | 639 N Highway 231, Panama City, FL 32405-4704 | 2020-07-15 |
| 1114540416 | Ramzy's Mediterranean Cafe Pharmacy, Inc | Pharmacy | 8740 N Kendall Dr Ste 106, Miami, FL 33176-2209 | 2020-05-20 |
| 1023643707 | Ops International Incorporated | Pharmacy | 4600 L B Mcleod Rd, Orlando, FL 32811-6454 | 2020-03-03 |
| 1639709454 | Medstop | Pharmacy | 2095 W Fairbanks Ave, Winter Park, FL 32789-4543 | 2020-01-21 |
| 1922644491 | My Prescription Coach, LLC | Pharmacy | 5008 W. Linebaugh Avenue, Suites 33 &34, Tampa, FL 33624-5038 | 2019-11-20 |
| 1346709540 | Pharmacygo, Inc | Pharmacy | 20041 S Tamiami Trl Ste 13, Estero, FL 33928-2228 | 2019-03-18 |
| 1124596150 | Rx for All Pharmacy Corp | Pharmacy | 1325 Nw 93rd Ct Ste B109, Doral, FL 33172-2835 | 2018-11-07 |
| 1710472451 | Caring Rx, LLC | Pharmacy | 21002 S Ridgewood Ave, Suite 2, Edgewater, FL 32141 | 2018-06-26 |
| 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.