Provider Demographics
NPI:1396917381
Name:PARTNERS PHARMACY OF FLORIDA, LLC
Entity type:Organization
Organization Name:PARTNERS PHARMACY OF FLORIDA, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF THIRD PARTY ADMINISTRAT
Authorized Official - Prefix:
Authorized Official - First Name:KELLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:GLADWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-931-9111
Mailing Address - Street 1:50 LAWRENCE RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07081-3121
Mailing Address - Country:US
Mailing Address - Phone:201-563-4592
Mailing Address - Fax:407-829-7346
Practice Address - Street 1:45 SKYLINE DR
Practice Address - Street 2:SUITE 1011
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-6224
Practice Address - Country:US
Practice Address - Phone:407-805-8300
Practice Address - Fax:407-829-7346
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-31
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH264313336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2011282OtherPK