Aetna Specialty Pharmacy, Llc

LBN: Aetna Specialty Pharmacy, Llc
Aetna Specialty Pharmacy, Llc is an health care organization with primary practice located at 503 Sunport Lane , Orlando FL 32809-7874. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Home Infusion Therapy Pharmacy, Suppliers / Specialty Pharmacy. Suppliers / Specialty Pharmacy is the primary health care specialty. Aetna Specialty Pharmacy, Llc can be contacted via phone (407) 513-6400, or through Carney, Jean R. via phone (407) 513-6495.

Contact Information

Primary practice address
503 Sunport Lane Orlando FL 32809-7874
Phone: (407) 513-6400
Fax: (866) 329-2779
Website:
Map and Directions
Authorized official contact:
Name: Carney, Jean R.
Phone: (407) 513-6495

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Home Infusion Therapy Pharmacy 3336H0001X PH21035 Florida
Suppliers / Specialty Pharmacy 3336S0011X PH21035 Florida

Profile Details

NPI number 1942203187
LBN Legal business name Aetna Specialty Pharmacy, Llc
DBA Doing business as
Authorized official Carney, Jean R.
Entity Organization
Organization subpart 1 No
Enumeration date May 23rd, 2005
Last updated May 19th, 2014 - about 10 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1942203187 NPPES
Hawaii MEDICAID 582713
Hawaii MEDICAID 6029037
Hawaii Other 1714655
Hawaii MEDICAID 200369680A
Hawaii MEDICAID 411068400
Hawaii MEDICAID 035123
Hawaii Other 3726379
Hawaii MEDICAID 0720789
Hawaii Other 7446672
Hawaii MEDICAID 0215059
Hawaii MEDICAID 030961300
Hawaii MEDICAID 35123
Hawaii Other 3726379
Hawaii Other 7446672
Hawaii MEDICAID 807415000
Hawaii MEDICAID PH575FL
Hawaii MEDICAID 1016502540001
Hawaii MEDICAID 38457750
Hawaii MEDICAID 1942203187
Hawaii MEDICAID 200077510A
Hawaii MEDICAID 7F1035
Hawaii MEDICAID 057738300
Hawaii MEDICAID 100508643
Hawaii MEDICAID 200808960A
Hawaii MEDICAID 432182200

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