Provider Demographics
NPI:1528358116
Name:ORLANDO HEALTH INC
Entity Type:Organization
Organization Name:ORLANDO HEALTH INC
Other - Org Name:SCRIPTS PHARMACY
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:RPH
Authorized Official - Phone:321-843-8535
Mailing Address - Street 1:1414 KUHL AVE STE MP-10
Mailing Address - Street 2:SUITE MP-10
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-2008
Mailing Address - Country:US
Mailing Address - Phone:321-841-1648
Mailing Address - Fax:
Practice Address - Street 1:92 W MILLER ST # MP374
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-2032
Practice Address - Country:US
Practice Address - Phone:321-841-1648
Practice Address - Fax:321-841-9102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-15
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0004X
FLPH253813336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL003685400Medicaid
2129846OtherPK
FL003685401Medicaid