AETNA SPECIALTY PHARMACY LLC NPI 1942203187

NPI Information

NPI: 1942203187
Provider Name: AETNA SPECIALTY PHARMACY, LLC
Classification: Pharmacy - 3336S0011X
Entity Type: Organization

Specialization: Specialty Pharmacy

Address:
503 SUNPORT LANE
ORLANDO, FL
ZIP 32809
Phone: (407) 513-6400
Get Directions

AETNA SPECIALTY PHARMACY, LLC is a specialty pharmacy pharmacy in Orlando, FL. The provider is a pharmacy that dispenses generally low volume and high cost medicinal preparations to patients who are undergoing intensive therapies for illnesses that are generally chronic, complex and potentially life threatening. Often these therapies require specialized delivery and administration. AETNA SPECIALTY PHARMACY, LLC NPI is 1942203187. The provider is registered as an organization entity type.

The provider's business location address is:

503 SUNPORT LANE
ORLANDO, FL
ZIP 32809-874
Phone: (407) 513-6400
Fax: (866) 329-2779

The provider's authorized official is Jean R. Carney .
The authorized official title is Sr. Pharmacy Ops Mgr and has the following contact phone number (407) 513-6495.

The enumeration date for this NPI number is 5/23/2005 and was last updated on 5/19/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	3336H0001X	Pharmacy	Home Infusion Therapy Pharmacy	PH21035	FLORIDA	No
2	3336S0011X	Pharmacy	Specialty Pharmacy	PH21035	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	=========001	MEDICAID	ILLINOIS
2	5328000002	MEDICARE NSC
3	1942203187	MEDICAID	VIRGINIA
4	200369680A	MEDICAID	KANSAS
5	432182200	MEDICAID	MAINE
6	057738300	MEDICAID	MINNESOTA
7	035123	MEDICAID	ARIZONA
8	7F1035	MEDICAID	SOUTH CAROLINA
9	=========001	MEDICAID	UTAH
10	0215059	MEDICAID	MONTANA
11	200077510A	MEDICAID	OKLAHOMA
12	35123	MEDICAID	ARIZONA
13	807415000	MEDICAID	IDAHO
14	3726379	OTHER		AETNA HEALTHCARE HMO CLAIMS
15	1016502540001	MEDICAID	PENNSYLVANIA
16	030961300	MEDICAID	FLORIDA
17	PH575FL	MEDICAID	ALASKA
18	U4870	MEDICARE PIN	FLORIDA
19	411068400	MEDICAID	MARYLAND
20	582713	MEDICAID	HAWAII
21	1714655	OTHER		AETNA HEALTHCARE
22	38457750	MEDICAID	NEW MEXICO
23	100508643	MEDICAID	NEVADA
24	0720789	MEDICAID	IOWA
25	6029037	MEDICAID	WASHINGTON
26	5328000002	MEDICARE PIN
27	7446672	OTHER		AETNA HEALTHCARE DIEM CLM
28	3726379	OTHER		AETNA HEALTHCARE HMO CLMS
29	7446672	OTHER		AETNA HEALTHCARE DIEM CLAIM
30	200808960A	MEDICAID	INDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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