MEDICARE: COASSIST PHARMACY, 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	3336C0003X	Community/Retail Pharmacy
2	3336C0003X	Community/Retail Pharmacy	PH30591	FL

General Provider Information

NPI Number	:	1588101356
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COASSIST PHARMACY, LLC

Provider Business Mailing Address
First Line	:	2400 SAND LAKE RD STE 200
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32809-9100
Country	:	US
Telephone Number	:	855-382-2533
Fax Number	:

Provider Business Practice Location Address
First Line	:	2400 SAND LAKE ROAD
Second Line	:	SUITE 200
City	:	ORLANDO
State	:	FL
Zip	:	32809
Country	:	US
Telephone Number	:	855-382-2533
Fax Number	:	833-596-2174

Authorized Official
Title or Position	:	VP, PHARMACY
Name	:	MR. SEAN JOHNSTON
Credential	:
Telephone Number	:	855-382-2533

Provider Enumeration Date	:	01/31/2017
Last Update Date	:	02/04/2026

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