Provider Demographics
NPI:1861687279
Name:ACARIAHEALTH PHARMACY INC
Entity Type:Organization
Organization Name:ACARIAHEALTH PHARMACY INC
Other - Org Name:ACARIAHEALTH PHARMACY INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:JENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-511-5144
Mailing Address - Street 1:8427 SOUTHPARK CIR
Mailing Address - Street 2:SUITE 400
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-9058
Mailing Address - Country:US
Mailing Address - Phone:855-422-2742
Mailing Address - Fax:866-834-8523
Practice Address - Street 1:2924 TELESTAR CT
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-1206
Practice Address - Country:US
Practice Address - Phone:800-511-5144
Practice Address - Fax:866-834-8523
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-10
Last Update Date:2020-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332BP3500X, 3336C0003X, 3336S0011X
LAPHY.0071843336S0011X
GAPHNR0006463336S0011X
MDP062233336S0011X
FLPH282203336S0011X
KYVA17113336S0011X
NC126243336S0011X
PANP0002183336S0011X
NVPH029783336S0011X
MNNR2650133336S0011X
NY0326053336S0011X
OK99-72503336S0011X
AZY0058603336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2106302OtherPK
WV3810030190Medicaid
VA1861687279Medicaid
SC7V4179Medicaid
MD422527900Medicaid
DC67080400Medicaid
6101350003Medicare NSC