Provider Demographics
NPI:1922569508
Name:ADVENTIST HEALTH SYSTEM- SUNBELT INC ADVENTHEALTH ORLANDO
Entity Type:Organization
Organization Name:ADVENTIST HEALTH SYSTEM- SUNBELT INC ADVENTHEALTH ORLANDO
Other - Org Name:ADVENTHEALTH OUTPATIENT PHARMACY ALTAMONTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-303-7388
Mailing Address - Street 1:PO BOX 540419
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32854-0419
Mailing Address - Country:US
Mailing Address - Phone:407-303-3438
Mailing Address - Fax:407-303-3439
Practice Address - Street 1:661 E ALTAMONTE DRIVE STE 116
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701
Practice Address - Country:US
Practice Address - Phone:407-303-3438
Practice Address - Fax:407-303-3439
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADVENTIST HEALTH SYSTEM-SUNBELT INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-03-27
Last Update Date:2019-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy