Provider Demographics
NPI:1003169699
Name:S & B HEALTH SYSTEMS LLC
Entity Type:Organization
Organization Name:S & B HEALTH SYSTEMS LLC
Other - Org Name:WEST COCOA PHARMACY AND COMPOUNDING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:BUTTERFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-305-6909
Mailing Address - Street 1:2711 CLEARLAKE RD # C-10
Mailing Address - Street 2:
Mailing Address - City:COCOA
Mailing Address - State:FL
Mailing Address - Zip Code:32922-5721
Mailing Address - Country:US
Mailing Address - Phone:321-305-6909
Mailing Address - Fax:321-305-6919
Practice Address - Street 1:2711 CLEARLAKE RD # C-10
Practice Address - Street 2:
Practice Address - City:COCOA
Practice Address - State:FL
Practice Address - Zip Code:32922-5721
Practice Address - Country:US
Practice Address - Phone:321-305-6909
Practice Address - Fax:321-305-6919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-19
Last Update Date:2013-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0004X, 3336L0003X, 3336S0011X
FLPH263903336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2136033OtherPK
FL007213700Medicaid