Provider Demographics
NPI:1407938897
Name:ONCOLOGY SPECIALTY PHARMACY, LLC
Entity Type:Organization
Organization Name:ONCOLOGY SPECIALTY PHARMACY, LLC
Other - Org Name:BAPTIST HEALTH SPECIALTY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF PHARMACY
Authorized Official - Prefix:MRS
Authorized Official - First Name:MADELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMEJO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-662-7111
Mailing Address - Street 1:14412 COMMERCE WAY
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33016-1508
Mailing Address - Country:US
Mailing Address - Phone:786-527-8200
Mailing Address - Fax:
Practice Address - Street 1:14412 COMMERCE WAY
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33016-1508
Practice Address - Country:US
Practice Address - Phone:786-527-8200
Practice Address - Fax:305-279-7068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH 21135333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL013909300Medicaid
FL030986900Medicaid