Healthcare Provider Details

I. General information

NPI: 1326032210
Provider Name (Legal Business Name): FIVE POINTS PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1108 LAKE DR
COCOA FL
32922-8678
US

IV. Provider business mailing address

1108 LAKE DR
COCOA FL
32922-8678
US

V. Phone/Fax

Practice location:
  • Phone: 321-636-8433
  • Fax: 407-634-5003
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPH0002574
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DONNA HARRISON FLINT
Title or Position: MGR
Credential:
Phone: 321-636-8433