Provider Demographics
NPI:1730273152
Name:ADVENTIST HEALTH SYSTEM-SUNBELT INC
Entity type:Organization
Organization Name:ADVENTIST HEALTH SYSTEM-SUNBELT INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:407-303-7388
Mailing Address - Street 1:PO BOX 540419
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32854
Mailing Address - Country:US
Mailing Address - Phone:407-303-4005
Mailing Address - Fax:407-303-4443
Practice Address - Street 1:400 CELEBRATION PLACE
Practice Address - Street 2:ATTN: PHARMACARE CENTER PHARMACY
Practice Address - City:CELEBRATION
Practice Address - State:FL
Practice Address - Zip Code:34747
Practice Address - Country:US
Practice Address - Phone:407-303-4005
Practice Address - Fax:407-303-4305
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADVENTIST HEALTH SYSTEM/SUNBELT, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-02
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH156753336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL106260300Medicaid
FL1081948OtherNABP NUMBER
FLPH15675OtherPHARMACY LICENSE NUMBER
FL106260301Medicaid
FL106260301Medicaid