Space Coast Community Pharmacy

LBN: Crayton Mitchell Group
Space Coast Community Pharmacy is an health care organization with primary practice located at 197 Bougainvillea Dr Ste D , Rockledge FL 32955-2402. The organization recently has 4 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Customized Equipment, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Crayton Mitchell Group can be contacted via phone (321) 636-2275, or through Mitchell, Traci via phone (321) 636-2275.

Contact Information

Primary practice address
197 Bougainvillea Dr Ste D Rockledge FL 32955-2402
Phone: (321) 636-2275
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Mitchell, Traci
Phone: (321) 636-2275

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X PH29873 Florida
Suppliers / Customized Equipment 332BC3200X PH29873 Florida
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X PH29873 Florida

Profile Details

NPI number 1851750178
LBN Legal business name Crayton Mitchell Group
DBA Doing business as Space Coast Community Pharmacy
Authorized official Mitchell, Traci
Entity Organization
Organization subpart 1 No
Enumeration date Feb 15th, 2016
Last updated Jan 28th, 2020 - about 4 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1851750178 NPPES
Other 2158119 PK

Popular Providers