Provider Demographics
NPI:1912126087
Name:APPLE PHARMACY SERVICES INC
Entity Type:Organization
Organization Name:APPLE PHARMACY SERVICES INC
Other - Org Name:APPLE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:
Authorized Official - Last Name:MERCIER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:941-475-0061
Mailing Address - Street 1:500 N INDIANA AVE
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:34223-2704
Mailing Address - Country:US
Mailing Address - Phone:941-475-0061
Mailing Address - Fax:941-475-0097
Practice Address - Street 1:500 N INDIANA AVE
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:FL
Practice Address - Zip Code:34223-2704
Practice Address - Country:US
Practice Address - Phone:941-475-0061
Practice Address - Fax:941-475-0097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2012-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
FLPH 110243336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL100933800Medicaid
1064194OtherNCPDP PROVIDER IDENTIFICATION NUMBER
FL100933800Medicaid