MEDICARE: HEALTHDYNE PHARMACY FL, LLC

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	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy
3	3336M0002X	Mail Order Pharmacy	PH23389	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	2011832	OTHER	PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
11	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
12	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
13	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
14	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
15	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
16	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093974982
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTHDYNE PHARMACY FL, LLC

Provider Business Mailing Address
First Line	:	500 EAGLES LANDING DR
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33810-2899
Country	:	US
Telephone Number	:	888-479-2000
Fax Number	:	863-686-4710

Provider Business Practice Location Address
First Line	:	500 EAGLES LANDING DR
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33810-2899
Country	:	US
Telephone Number	:	888-479-2000
Fax Number	:	863-686-5682

Authorized Official
Title or Position	:	SENIOR VICE PRESIDENT&SECRETARY
Name	:	PHILLIP P BISESI
Credential	:
Telephone Number	:	863-583-6248

Provider Enumeration Date	:	06/05/2008
Last Update Date	:	08/12/2025

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MEDICARE: HEALTHDYNE PHARMACY FL, LLC

Scope of Practice

Other Identifiers

General Provider Information

Similar Medicare Providers

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