CRAYTON MITCHELL GROUP (NPI# 1851750178) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851750178 |
| Entity Type | Organization |
| Organization Name | CRAYTON MITCHELL GROUP |
| Other Organization Name | SPACE COAST COMMUNITY PHARMACY |
| Practice Address |
197 Bougainvillea Dr Ste D Rockledge FL 32955-2402 |
| Practice Telephone | 3216362275 |
| Mailing Telephone | 3216362275 |
| Enumeration Date | 2016-02-15 |
| Last Update Date | 2020-01-28 |
| Authorized Official Name | TRACI MITCHELL (OWNER) |
| Authorized Official Telephone | 3216362275 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | PH29873 | FL | Suppliers |
| N | 332BC3200X |
Durable Medical Equipment & Medical Supplies Specialization: Customized Equipment |
PH29873 | FL | Suppliers |
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
PH29873 | FL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2158119 | 01 |
| Other Name | Type Code |
|---|---|
| Space Coast Community Pharmacy | Doing Business As Name - Organization |
| Street Address |
197 BOUGAINVILLEA DR STE D |
| City | ROCKLEDGE |
| State | FL |
| Zip Code | 32955-2402 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477169571 | Health First Medical Group LLC | Orthopaedic Surgery | 6525 3rd Street, #302, Rockledge, FL 32955 | 2020-09-23 |
| 1063037810 | Endo Now LLC | Internal Medicine | 5460 Village Drive,viera, Rockledge, FL 32955 | 2020-06-08 |
| 1588285100 | Enrique Technologies & Trading, LLC | Meals | 1841 Long Iron Dr. Ste. 805, Rockledge, FL 32955 | 2020-05-05 |
| 1578101549 | Ericka Marshall | Counselor | 7095 Turner Road, Rockledge, FL 32955 | 2019-12-20 |
| 1174168322 | Brevard Pharmacy L.L.C. | Pharmacy | 401. Barton Blvd., Rockledge, FL 32955 | 2019-11-12 |
| 1770131443 | Fyzical Therapy & Balance Center Rockledge-viera | Clinic/Center | 634 Barnes Boulevard, Unit 202, Rockledge, FL 32955 | 2019-08-27 |
| 1699261461 | Brookview Manor Assisted Living Facility LLC | Assisted Living Facility | 882 Brookview Ln, Rockledge, FL 32955 | 2018-07-05 |
| 1750888970 | Kaitlin Donovan | Dentist | 5380 Stadium Pkwy Ste 119, Rockledge, FL 32955 | 2018-04-13 |
| 1376041327 | Serina Eder | Acupuncturist | 5595 Schenck Ave Ste 7, Rockledge, FL 32955 | 2018-01-24 |
| 1427563394 | Suntree Orthopedics, LLC | Orthopaedic Surgery | 6525 3rd St Ste 302-303, Rockledge, FL 32955 | 2017-12-13 |
| Find all providers in zip 32955 | ||||
| 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 |
|---|---|---|---|---|
| 1891899779 | Holiday Cvs LLC | Pharmacy | 1696 Fiske Blvd, Rockledge, FL 32955-2535 | 2006-09-12 |
| 1124122049 | Holiday Cvs LLC | Pharmacy | 1820 Rockledge Blvd, Rockledge, FL 32955-2822 | 2006-09-12 |
| 1811539687 | Brevard Health Alliance Inc | Pharmacy | 220 Barton Blvd Unit C14, Rockledge, FL 32955-2742 | 2019-10-14 |
| 1003121856 | City Discount Pharmacy | Pharmacy | 1260 Us Highway 1, Rockledge, FL 32955-2728 | 2010-08-17 |
| 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.