WINN DIXIE PHARMACY # 81 (NPI# 1124058318) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124058318 |
| Entity Type | Organization |
| Organization Name | WINN DIXIE PHARMACY # 81 |
| Practice Address |
580 South Marion Lake City FL 32055 |
| Mailing Address |
Po Box 850001 Orlando FL 32885-0231 |
| Practice Telephone | 3867550997 |
| Practice Fax Number | 3867553192 |
| Mailing Telephone | 9043706106 |
| Mailing Fax Number | 9043707218 |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. DAVID YOUNG (DIVISION SUPPORT MANAGER) |
| Authorized Official Telephone | 9043706365 |
| Authorized Official Credential | M. D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | PH9775 | FL | Pharmacy Service Providers |
| Street Address |
580 SOUTH MARION |
| City | LAKE CITY |
| State | FL |
| Zip Code | 32055 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114439510 | Melissa Fay Peters | Nurse Practitioner | 5085 West Us Highway 90, Lake City, FL 32055 | 2017-10-26 |
| 1851801765 | Stephanie Jo Nogle | Occupational Therapist | Brooks Americare: 4251 Nw American Ln, #103, Lake City, FL 32055 | 2017-10-05 |
| 1831617273 | Erica Mayo | Pharmacist | 4846 Nw Lake Jeffery Rd., Lake City, FL 32055 | 2017-09-06 |
| 1144759333 | Jerry Hamilton Cheesman | Dentist | 217 Ne Franklin Sreet, Lake City, FL 32055 | 2017-06-09 |
| 1487183745 | Joshua Allore | Dentist | 2970 W Us Highway 90., Lake City, FL 32055 | 2017-06-08 |
| 1497298418 | Careing Hands | Preferred Provider Organization | 1471nw Queen Rd, Lakecity, FL 32055 | 2016-11-22 |
| 1881148278 | Corniqueca Stewart-simmons | Nurse Practitioner | 340 Nw Commerce Drive, Lake City, FL 32055 | 2016-08-15 |
| 1164809141 | Latasha Harten-jones | Licensed Practical Nurse | 443 Ne Sims Dr, Lake City, FL 32055 | 2015-04-29 |
| 1154716447 | Lindsey Morton | Counselor | 219 Se Baya Avenue, Lake City, FL 32055 | 2015-04-02 |
| 1124439351 | Tynette Jordan | Counselor | 708 N.w Wilson St., Lake City, FL 32055 | 2014-05-09 |
| Find all providers in zip 32055 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053910943 | Colleen Courey | Pharmacist | 1465 W Us Highway 90 Ste 110, Lake City, FL 32055-6154 | 2020-10-21 |
| 1801438353 | Jennifer Bennett | Pharmacist | 347 Sw Main Blvd Suite 102, Lake City, FL 32025 | 2019-10-16 |
| 1831617273 | Erica Mayo | Pharmacist | 4846 Nw Lake Jeffery Rd., Lake City, FL 32055 | 2017-09-06 |
| 1932626009 | Trinity H Williams | Pharmacist | 340 Nw Commerce Dr Fl 32055, Lake City, FL 32055-4709 | 2017-08-29 |
| 1215476601 | Emily Wilson | Pharmacist | 347 Sw Main Blvd Ste 102, Lake City, FL 32025-5262 | 2017-02-17 |
| 1861867566 | Denita Alison Pleasant | Pharmacist | 301 West Thomas Street, Lake City, SC 29560 | 2015-12-07 |
| 1467850974 | Michael Eric Johnson | Pharmacist | 161 Sw Stonegate Ter, Suite 105, Lake City, FL 32024-3452 | 2014-12-15 |
| 1700297652 | Sharon Lewis | Pharmacist | 900 Us Highway 52, Lake City, SC 29560 | 2014-05-14 |
| 1376954305 | Sergio Montes | Pharmacist | 900 Us Hwy 52, Lake City, SC 29560 | 2014-05-13 |
| 1992122857 | Paula Moses | Pharmacist | 900 U.s Hwy. 52, Lake City, SC 29560 | 2014-03-27 |
| Find all providers in LAKE CITY | ||||
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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.