Provider Demographics
NPI:1346595501
Name:SPECIALTY PHARMACY NURSING NETWORK, INC.
Entity Type:Organization
Organization Name:SPECIALTY PHARMACY NURSING NETWORK, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CFO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAPIRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-879-6137
Mailing Address - Street 1:3000 LAKESIDE DRIVE 300N
Mailing Address - Street 2:
Mailing Address - City:BANNOCKBURN
Mailing Address - State:IL
Mailing Address - Zip Code:60015-5405
Mailing Address - Country:US
Mailing Address - Phone:800-879-6137
Mailing Address - Fax:847-332-0298
Practice Address - Street 1:1626 BARBER RD., SUITE B
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34240-9301
Practice Address - Country:US
Practice Address - Phone:877-330-7766
Practice Address - Fax:941-366-7361
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-13
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1135314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility