AGEVITAL PHARMACY, LLC (NPI# 1730428897) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730428897 |
| Entity Type | Organization |
| Organization Name | AGEVITAL PHARMACY, LLC |
| Practice Address |
16 S Blvd of The Presidents Sarasota FL 34236-1424 |
| Practice Telephone | 9419288066 |
| Mailing Telephone | 9419288066 |
| Enumeration Date | 2013-02-10 |
| Last Update Date | 2013-02-10 |
| Authorized Official Name | JENNY P. WILKINS (PROPRIETOR/GENERAL MANAGER) |
| Authorized Official Telephone | 9419288066 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| Y | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
Suppliers |
| Street Address |
16 S BLVD OF THE PRESIDENTS |
| City | SARASOTA |
| State | FL |
| Zip Code | 34236-1424 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679065122 | Pines of Sarasota Healthcare, LLC | Assisted Living Facility | 1251 N Orange Ave, Sarasota, FL 34236 | 2018-05-31 |
| 1053800995 | Susan Grace Swinnerton | Counselor | 1753 Ringling Boulevard, Sarasota, FL 34236 | 2018-05-07 |
| 1457892895 | Smart Living Coaching Services LLC | Psychologist | 1188 N Tamiami Trl Unit 205b, Sarasota, FL 34236 | 2017-03-18 |
| 1427595784 | Lisa Johnson Physical Therapy, Pllc | Physical Therapist | 1451 2nd St, Sarasota, FL 34236 | 2017-01-25 |
| 1003362302 | Jennifer Dawson | Counselor | 1565 State St., Sarasota, FL 34236 | 2016-08-28 |
| 1548662141 | Lanneka White | Nurse Practitioner | 1990 Main Street Suite 750 Unit 738, Sarasota, FL 34236 | 2014-09-25 |
| 1215200878 | Gt Spiritual Enterprises, Inc. | Acupuncturist | 25 South Osprey Avenue, Sarasota, FL 34236 | 2012-02-13 |
| 1225315070 | Michelle Celeste Berhen | Physical Therapist | 1058 N Tamiami Trail 108-280, Sarasota, FL 34236 | 2011-11-08 |
| 1730412701 | My Smile Dentistry | Dentist | 846 South Osprey Avenue, Sarasota, FL 34236 | 2009-09-09 |
| 1134361587 | Kasy Willie Kane | Counselor | 310 South Osprey Avenue, Sarasota, FL 34236 | 2009-04-01 |
| Find all providers in zip 34236 | ||||
| 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 |
|---|---|---|---|---|
| 1952611329 | Shubhom Healthcare LLC | Pharmacy | 3600 S Tuttle Ave, Sarasota, FL 34239-6407 | 2010-10-19 |
| 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 | ||||
Please comment or provide details below to improve the information on AGEVITAL PHARMACY, LLC.
| 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.