Acquaviva'S Pharmacy
LBN: Carl D Acquaviva
Acquaviva'S Pharmacy is an health care organization with primary practice located at 1555 Port Malabar Blvd Ne Unit 101, Palm Bay FL 32905-5407. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Carl D Acquaviva can be contacted via phone (321) 725-7188, or through Acquaviva, Carl D via phone (321) 725-7188.
Contact Information
Primary practice address
1555 Port Malabar Blvd Ne Unit 101
Palm Bay FL 32905-5407
Phone: (321) 725-7188
Fax: (321) 728-1333
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X | ||
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | PH10316 | Florida |
Profile Details
| NPI number | 1013928514 |
|---|---|
| LBN Legal business name | Carl D Acquaviva |
| DBA Doing business as | Acquaviva'S Pharmacy |
| Authorized official | Acquaviva, Carl D RPH |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Aug 10th, 2006 |
| Last updated | Apr 2nd, 2009 - about 15 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1013928514 | NPPES |
| Other | 1038036 | NCPDP PROVIDER IDENTIFICATION NUMBER | |
| MEDICAID | 104293901 | NCPDP PROVIDER IDENTIFICATION NUMBER | |
| MEDICAID | 104293900 | NCPDP PROVIDER IDENTIFICATION NUMBER |
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