1598765570 NPI number — BIOPLUS SPECIALTY PHARMACY, INC.

Table of content: (NPI 1598765570)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598765570 NPI number — BIOPLUS SPECIALTY PHARMACY, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BIOPLUS SPECIALTY PHARMACY, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1598765570
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/16/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3200 LAKE EMMA RD UNIT 1000
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAKE MARY
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32746-3358
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
855-733-3126
Provider Business Mailing Address Fax Number:
888-315-3270

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3200 LAKE EMMA RD UNIT 1000
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAKE MARY
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32746-3358
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
855-733-3126
Provider Business Practice Location Address Fax Number:
888-315-3270
Provider Enumeration Date:
07/29/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SHEEHAN
Authorized Official First Name:
ASHLEY
Authorized Official Middle Name:
Authorized Official Title or Position:
CREDENTIALING SPECIALIST
Authorized Official Telephone Number:
855-733-3126

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336S0011X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 333600000X , with the licence number: PH17230 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0018492980003 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 003119890 , issued by the state of ( CT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 022363800 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 057055900 , issued by the state of ( DC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1598765570 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1598765570 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1598765570 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3087712 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 416817800 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 500626260 , issued by the state of ( OR ) . This identifiers is of the category "MEDICAID".
  • Identifier: 536089 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".
  • Identifier: DM1317 , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0022363802 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1598765570 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 500628537 , issued by the state of ( OR ) . This identifiers is of the category "MEDICAID".
  • Identifier: 582023 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7038923 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0270686 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 03105699 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100444750A , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".