Aetna Specialty Pharmacy, Llc, NPI 1942203187
Specialty Pharmacy in Orlando, FL, US
NPI number: what is it?
The NPI, or National Provider Identifier, is a non-repeatable number for health care providers. The NPI always consists of 10 digits and is used for administrative and financial procedures. The NPI wa...
| NPI | 1942203187 |
| NPI Entity Type | Organization |
| Provider Name | Aetna Specialty Pharmacy, Llc |
| Enumeration Date | September 30, 2009 |
| Last Update Date | September 30, 2009 |
| Provider Location Address | 503 Sunport Lane, Orlando, FL, US |
| Provider Mailing Address | 503 Sunport Lane, Orlando, FL, US, 328097874 |
| Is Sole Proprietor? | No |
Organization Official
| Official Name | Jean R. Carney |
| Official Position | SR. PHARMACY OPS MGR |
| Phone | 407-513-6495 |
Primary Taxonomy
| Taxonomy Code | |
| Taxonomy Name | Specialty Pharmacy |
| Classification | |
| Group | |
| License No. | PH21035 |
| License State | FL |
| Description | A pharmacy that dispenses generally low volume and high cost medicinal preparations to patients who are undergoing intensive therapies for illnesses that are generally chronic, complex and potentially life threatening. Often these therapies require specialized delivery and administration. |
Secondary Taxonomies
| Taxonomy Code | Group | Classification | License No. | State | Primary? |
|---|---|---|---|---|---|
| PH21035 | FL | No |
Other Identifiers
| Identifier | Identifier State | Identifier Issuer | Type/Code |
|---|---|---|---|
| 582713 | HI | MEDICAID | 05 |
| 6029037 | WA | MEDICAID | 05 |
| 1714655 | AETNA HEALTHCARE | 01 | |
| 200369680A | KS | MEDICAID | 05 |
| 411068400 | MD | MEDICAID | 05 |
| 035123 | AZ | MEDICAID | 05 |
| 3726379 | AETNA HEALTHCARE HMO CLMS | 01 | |
| 0720789 | IA | MEDICAID | 05 |
| 7446672 | AETNA HEALTHCARE DIEM CLAIM | 01 | |
| 0215059 | MT | MEDICAID | 05 |
| 030961300 | FL | MEDICAID | 05 |
| 35123 | AZ | MEDICAID | 05 |
| 3726379 | AETNA HEALTHCARE HMO CLAIMS | 01 | |
| 7446672 | AETNA HEALTHCARE DIEM CLM | 01 | |
| 807415000 | ID | MEDICAID | 05 |
| PH575FL | AK | MEDICAID | 05 |
| 1016502540001 | PA | MEDICAID | 05 |
| 38457750 | NM | MEDICAID | 05 |
| 1942203187 | VA | MEDICAID | 05 |
| 200077510A | OK | MEDICAID | 05 |
| 7F1035 | SC | MEDICAID | 05 |
| 057738300 | MN | MEDICAID | 05 |
| 100508643 | NV | MEDICAID | 05 |
| 200808960A | IN | MEDICAID | 05 |
| 432182200 | ME | MEDICAID | 05 |
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DR. M.D. Kimberley Kleckner Individual |
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MR. LMT Michell Pavoni Individual |
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APRN Kelsey Barton Friedman Individual |
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Hana Ann Steingold Individual |
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PHARMD Susmita Jasmine Samuel Individual |
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MS. ARNP Sylwia Anna Cyrwus Individual |
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MD Tiffani Mathew Individual |
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MR. MAT, ATC Robert Michael Shifrin Individual |
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OTR/L Raquel Ioia Individual |
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