MYCELIUM PHARMACY LLC (NPI# 1487252391) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487252391 |
| Entity Type | Organization |
| Organization Name | MYCELIUM PHARMACY LLC |
| Practice Address |
141 E Commercial Blvd Ft Lauderdale FL 33334-1623 |
| Practice Telephone | 9546165675 |
| Mailing Telephone | 9546165675 |
| Enumeration Date | 2020-10-13 |
| Last Update Date | 2020-10-13 |
| Authorized Official Name | MR. MARKO JARIC (OWNER) |
| Authorized Official Telephone | 9546165675 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 333600000X | Pharmacy | Suppliers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | MYCELIUM PHARMACY LLC | 141 E Commercial Blvd, Fort Lauderdale, Fl 33334 |
| Street Address |
141 E COMMERCIAL BLVD |
| City | FT LAUDERDALE |
| State | FL |
| Zip Code | 33334-1623 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245755644 | Fusion Health & Wellness LLC | Counselor | 1164 E Oakland Park Blvd Ste 102, Oakland Park, FL 33334 | 2017-08-07 |
| 1376064063 | The Senior Spot | Custodial Care Facility | 410 E Oakland Park Blvd., Wilton Manors, FL 33334 | 2017-07-03 |
| 1952831810 | Andrew Morgan | Counselor | 450 Ne 44th Street, Oakland Park, FL 33334 | 2017-06-14 |
| 1033561907 | Trevor Howe Hart | Dentist | 3425 N Dixie Hwy, Oakland Park, FL 33334 | 2016-07-05 |
| 1548646698 | Shelly Vilsaint | Massage Therapist | 120 E. Oakland Park Blvd, Suite 208, Fort Lauderdale, FL 33334 | 2015-07-30 |
| 1295129641 | Kristin Joann Biggie | Pediatrics | 5333 N Dixie Highway, Suite 106, Fort Lauderdale, FL 33334 | 2015-03-24 |
| 1235529116 | Rodolfo Herrera Barter | General Practice | 735 E Oakland Park Blvd, Oakland Park, FL 33334 | 2015-01-29 |
| 1639573629 | Garrick Edwards | Health Educator | 1501 Ne 62nd Street, Ft. Lauderdale, FL 33334 | 2014-10-20 |
| 1568877967 | Michael James Breen Jr. | Occupational Therapist | 1000 Corporate Dr #280, Centra Healthcare, Fort Lauderdale, FL 33334 | 2014-06-24 |
| 1144649161 | Passage Health International | Case Management | 701 E Commercial Blvd Fl 4, Oakland Park, FL 33334 | 2014-04-08 |
| Find all providers in zip 33334 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| 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: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467085985 | Prevent Rx, LLC | Pharmacy | 906 W Sunrise Blvd Ste B, Ft Lauderdale, FL 33311-7131 | 2020-02-13 |
| 1770135162 | Superior Drugs, Inc | Pharmacy | 3947 Davie Blvd, Ft Lauderdale, FL 33312-3405 | 2019-07-15 |
| 1427350479 | Sunrise Natural Pharmacy, LLC | Pharmacy | 925 N Federal Hwy, Ft Lauderdale, FL 33304-2706 | 2010-11-24 |
| 1073815106 | Liberty Pharmacy LLC | Pharmacy | 5443 N Federal Hwy, Ft Lauderdale, FL 33308-3206 | 2010-11-22 |
| 1336463678 | Friendly Pharmacy Inc | Pharmacy | 1623 S Andrews Ave, Ft Lauderdale, FL 33316-2509 | 2010-03-16 |
| 1053350827 | Publix Super Markets Inc | Pharmacy | 1940 Cordova Rd, Ft Lauderdale, FL 33316-2156 | 2006-06-06 |
| 1558461913 | Medic Pharmacy Inc | Pharmacy | 5150 N Federal Hwy, Ft Lauderdale, FL 33308-3814 | 2006-09-25 |
| 1548288087 | North Broward Hospital District | Pharmacy | 1600 S Andrews Ave, Ft Lauderdale, FL 33316-2510 | 2006-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306452974 | Curry Ford Pharmacy LLC | Pharmacy | 4538 Curry Ford Rd, Orlando, FL 32812-2711 | 2020-09-19 |
| 1225641525 | Englewood Pharmaceutical Services Inc | Pharmacy | 1720 S Mccall Rd Ste J, Englewood, FL 34223-4867 | 2020-08-26 |
| 1972115103 | Intellrx Consulting LLC | Pharmacy | 1257 The 12th Fairway, Wellington, FL 33414-5738 | 2020-08-19 |
| 1518577576 | Publix Super Markets, Inc | Pharmacy | 7340 Kathleen Rd, Lakeland, FL 33810-4495 | 2020-08-05 |
| 1962011890 | Green Star Pharmacy | Pharmacy | 2950 Winkler Ave Ste 701, Fort Myers, FL 33916-9322 | 2020-07-27 |
| 1356959134 | Cverx Pharmacy Corp | Pharmacy | 7360 Sw 24th St Ste 29, Miami, FL 33155-1462 | 2020-07-17 |
| 1447877287 | Jerry Voltaire | Pharmacy | 16470 Cedar Run Dr, Orlando, FL 32828-6970 | 2020-06-27 |
| 1598381980 | John Melvin Schemm IIi | Pharmacy | 7617 Bay Port Rd, Orlando, FL 32819-5504 | 2020-06-22 |
| 1891318267 | Empire Specialty Pharmacy LLC | Pharmacy | 749 S Apollo Blvd, Melbourne, FL 32901-1457 | 2020-05-20 |
| 1992334205 | Mypills Pharmacy LLC | Pharmacy | 303a E 1st St, Sanford, FL 32771-1377 | 2020-04-07 |
| Find all providers with the same taxonomy | ||||
| City | FT LAUDERDALE |
| Zip Code | 33334 |
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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.