Provider Demographics
NPI:1992178271
Name:INSIGHT PHARMACY LLC
Entity Type:Organization
Organization Name:INSIGHT PHARMACY LLC
Other - Org Name:INSIGHT PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:TOM
Authorized Official - Middle Name:
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-960-3784
Mailing Address - Street 1:1443 S ORLANDO AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-6436
Mailing Address - Country:US
Mailing Address - Phone:407-960-3784
Mailing Address - Fax:407-960-3786
Practice Address - Street 1:1443 S ORLANDO AVE STE B
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-6436
Practice Address - Country:US
Practice Address - Phone:407-960-3784
Practice Address - Fax:407-960-3786
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-09
Last Update Date:2015-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH29207333600000X
3336C0003X, 3336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2154998OtherPK