Mack Bayou Pharmacy LLC
NPI 1508112889ActiveOrganization· Pharmacy, Compounding Pharmacy· Santa Rosa Beach, FL
Pharmacy, Compounding Pharmacy in Santa Rosa Beach, Florida, registered in NPPES in July 2012. The authorized official on file is Amy Frazier, PHARMD, Owner.
Overview
| NPI | 1508112889 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 24, 2012 |
| Last updated in NPPES | Mar 1, 2017 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacy, Compounding Pharmacy Primary | 3336C0004X | PH26321 | FL |
| Pharmacy | 333600000X | — | — |
| Pharmacy, Community/Retail Pharmacy | 3336C0003X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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