MEDICARE: FIVE POINTS PHARMACY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy
2	333600000X	Pharmacy	PH0002574	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	1003160	OTHER		OTHER ID NUMBER-COMMERCIAL NUMBER

General Provider Information

NPI Number	:	1326032210
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FIVE POINTS PHARMACY

Provider Business Mailing Address
First Line	:	1108 LAKE DR
Second Line	:
City	:	COCOA
State	:	FL
Zip	:	32922-8678
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1108 LAKE DR
Second Line	:
City	:	COCOA
State	:	FL
Zip	:	32922-8678
Country	:	US
Telephone Number	:	321-636-8433
Fax Number	:	407-634-5003

Authorized Official
Title or Position	:	MGR
Name	:	DONNA HARRISON FLINT
Credential	:
Telephone Number	:	321-636-8433

Provider Enumeration Date	:	09/07/2005
Last Update Date	:	09/11/2025

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Directions to “FIVE POINTS PHARMACY ” Practice Location

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