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Contact Information

MARK CASEY PHILLIPS
100 N MAIN ST
HASTINGS, FL32145
 Phone: 904-692-4748
 Fax: 904-692-1085
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for MARK CASEY PHILLIPS

NPI Number 1861720559
LBN Legal business name MARK CASEY PHILLIPS
Authorized official MARK PHILLIPS - (PRESIDENT/PHCY OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 11/18/2009
Last updated 02/05/2013 - About 13 years ago
Identifiers
FL License # PH24460
FL Medicaid 002033800
Other 1050486 NCPDP PROVIDER IDENTIFICATION NUMBER
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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