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NPI 1689794810ActiveIndividual· Pharmacist· Fernandina Beach, FL
Pharmacist in Fernandina Beach, Florida, licensed in VA, FL and VI, with an NPI issued in March 2007.
Overview
| NPI | 1689794810 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | No |
| NPI issued | Mar 30, 2007 |
| Last updated in NPPES | Jun 29, 2026 |
| Certified by provider | Jun 29, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacist Primary | 183500000X | 0202205352 | VA |
| Pharmacist | 183500000X | PS60668 | FL |
| Pharmacist | 183500000X | 239 | VI |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 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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All 24 pharmacists in Fernandina Beach · All pharmacists in Florida