AETNA SPECIALTY PHARMACY, LLC (NPI# 1942203187) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942203187 |
| Entity Type | Organization |
| Organization Name | AETNA SPECIALTY PHARMACY, LLC |
| Practice Address |
503 Sunport Lane Orlando FL 32809-7874 |
| Practice Telephone | 4075136400 |
| Practice Fax Number | 8663292779 |
| Mailing Telephone | 4075136400 |
| Mailing Fax Number | 8663292779 |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2014-05-19 |
| Authorized Official Name | JEAN R. CARNEY (SR. PHARMACY OPS MGR) |
| Authorized Official Telephone | 4075136495 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336H0001X |
Pharmacy Specialization: Home Infusion Therapy Pharmacy |
PH21035 | FL | Suppliers |
| Y | 3336S0011X |
Pharmacy Specialization: Specialty Pharmacy |
PH21035 | FL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KS | 200369680A | 05 | |
| AETNA HEALTHCARE DIEM CLAIM | 7446672 | 01 | |
| MT | 0215059 | 05 | |
| IA | 0720789 | 05 | |
| MN | 057738300 | 05 | |
| AETNA HEALTHCARE HMO CLMS | 3726379 | 01 | |
| IN | 200808960A | 05 | |
| FL | 030961300 | 05 | |
| PA | 1016502540001 | 05 | |
| AETNA HEALTHCARE | 1714655 | 01 | |
| NM | 38457750 | 05 | |
| SC | 7F1035 | 05 | |
| AK | PH575FL | 05 | |
| OK | 200077510A | 05 | |
| MD | 411068400 | 05 | |
| AZ | 035123 | 05 | |
| VA | 1942203187 | 05 | |
| AETNA HEALTHCARE HMO CLAIMS | 3726379 | 01 | |
| HI | 582713 | 05 | |
| AETNA HEALTHCARE DIEM CLM | 7446672 | 01 | |
| NV | 100508643 | 05 | |
| AZ | 35123 | 05 | |
| ME | 432182200 | 05 | |
| WA | 6029037 | 05 | |
| ID | 807415000 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Massachusetts Corporations | AETNA SPECIALTY PHARMACY, LLC | 503 Sunport Lane, Orlando, FL 32809 |
| New York State Corporations | AETNA SPECIALTY PHARMACY, LLC | 503 Sunport Lane, Orlando, Fl 32809 |
| Indiana Business Entities | AETNA SPECIALTY PHARMACY, LLC | 503 Sunport Lane, Orlando, FL 32809 |
| Street Address |
503 SUNPORT LANE |
| City | ORLANDO |
| State | FL |
| Zip Code | 32809-7874 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922634765 | Junie Jean-philippe | Chiropractor | 7130 S Orange Blossom Trail Suite 148, Orlando, FL 32809 | 2020-03-12 |
| 1073030276 | Amanda Wiegert | Counselor | 6000 Lake Ellenor Drive, Orlando, FL 32809 | 2017-08-28 |
| 1780114330 | Fanny Vivas | Counselor | 8000 South Orange Avenue, Suite 111, Orlando, FL 32809 | 2017-06-15 |
| 1588101356 | Coassist Pharmacy, LLC | Pharmacy | 2400 Sand Lake Road, Suite 200, Orlando, FL 32809 | 2017-01-31 |
| 1306203872 | Greidis Villalobos | Counselor | 5957 Estella Way, Orlando, FL 32809 | 2016-01-28 |
| 1891113809 | Orville Mario Morgan | Genetic Counselor, MS | 1220 Evangeline Ave., Orlando, FL 32809 | 2014-04-07 |
| 1669727699 | Hispanic Family Counseling Inc | Social Worker | 6900 S Orange Blossom Trl Ste 402, Orlando, FL 32809 | 2012-07-16 |
| 1548529118 | Laurie Lowe Forbes | Pharmacist | 530 Sunport Lane, Orlando, FL 32809 | 2012-05-16 |
| 1972886307 | Viet H Nguyen | Pharmacist | 7003 Presidents Drive Suite 250, Orlando, FL 32809 | 2011-09-22 |
| 1497042774 | Calren S Wang | Physical Therapy Assistant | 1718 Colleen Dr, Belle Isle, FL 32809 | 2011-07-07 |
| Find all providers in zip 32809 | ||||
| Taxonomy Code | 3336S0011X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Specialty Pharmacy |
| A pharmacy that dispenses generally low volume and high cost medicinal preparations to patients who are undergoing intensive therapies for illnesses that are generally chronic, complex and potentially life threatening. Often these therapies require specialized delivery and administration. |
| 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: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467909580 | Walgreen Specialty Pharmacy LLC | Pharmacy | 8325 S Park Cir, Ste 200, Orlando, FL 32819-9075 | 2016-09-07 |
| 1376924266 | Univita of Florida, Inc. | Pharmacy | 2252 Commerce Park Dr Ste 100, Orlando, FL 32819-8609 | 2015-06-16 |
| 1114317898 | Life Worth Living Foundation Inc | Pharmacy | 6488 Currin Dr, Orlando, FL 32835-6207 | 2015-02-02 |
| 1437562642 | Performspecialty, LLC | Pharmacy | 2416 Lake Orange Dr, Sutie 190, Orlando, FL 32837-7812 | 2014-06-05 |
| 1750623641 | Jnt Healthcare LLC | Pharmacy | 1745 W Oak Ridge Rd, Orlando, FL 32809-3909 | 2013-03-19 |
| 1457618555 | Prime Therapeutics Specialty Pharmacy LLC | Pharmacy | 2354 Commerce Park Drive, Suite 100, Orlando, FL 32819 | 2012-04-13 |
| 1013934413 | Wal-mart Stores East Lp | Pharmacy | 9600 Parksouth Ct Ste 120, Suite 120, Orlando, FL 32837-6424 | 2006-07-16 |
| 1164472825 | Aids Healthcare Foundation | Pharmacy | 1701 N Mills Ave, Orlando, FL 32803-1851 | 2006-05-11 |
| 1528589439 | Publix Super Markers, Inc | Pharmacy | 1950 Sand Lake Rd Bldg 5, Orlando, FL 32809-7632 | 2017-06-30 |
| 1639524010 | Dr. Mark Bornstein Pharmacy | Pharmacy | 701 E Michigan St, Orlando, FL 32806-4623 | 2016-05-04 |
| Find all providers in ORLANDO | ||||
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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.