=====================================================
General NPI Number Information
=====================================================
NPI Number | 1922569508
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ADVENTIST HEALTH SYSTEM-SUNBELT INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/27/2019
-----------------------------------------------------
Last Update Date | 02/03/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 661 E ALTAMONTE DRIVE STE 116
-----------------------------------------------------
City | ALTAMONTE SPRINGS
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32701
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-303-3438
-----------------------------------------------------
Fax | 407-303-3439
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 540419
-----------------------------------------------------
City | ORLANDO
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32854-0419
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-303-3438
-----------------------------------------------------
Fax | 407-303-3439
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR
-----------------------------------------------------
Name | MR. HOWARD SMITH
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 407-303-7388
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------