Provider Demographics
NPI:1477616092
Name:ORLANDO HEALTH INC
Entity Type:Organization
Organization Name:ORLANDO HEALTH INC
Other - Org Name:ORLANDO HEALTH SCRIPTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CORPORATE MANAGER, RETAIL PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:ROXANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:BLANCHARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-843-8535
Mailing Address - Street 1:PO BOX 568624
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32856-8624
Mailing Address - Country:US
Mailing Address - Phone:321-843-8535
Mailing Address - Fax:
Practice Address - Street 1:1400 S ORANGE AVE
Practice Address - Street 2:MP 138
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-2134
Practice Address - Country:US
Practice Address - Phone:321-841-1647
Practice Address - Fax:321-841-2819
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336S0011X
FLPH224133336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL031882590Medicaid
FL031882501Medicaid
FL031882500Medicaid
2008197OtherPK
FL031882590Medicaid