GREY DOG IV INC NPI 1275019705

NPI Details

GREY DOG IV, INC is a community/retail pharmacy pharmacy in Key Biscayne, FL. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. GREY DOG IV, INC NPI is 1275019705. The provider is registered as an organization entity type.
The provider Is Doing Business As Ethos Wellness Pharmacy.

The provider's business location address is:

260 CRANDON BLVD STE 33
KEY BISCAYNE, FL
ZIP 33149-538
Phone: (305) 982-8727

The provider's authorized official is Rafael Parra .
The authorized official title is Treasurer and has the following contact phone number (305) 781-7768.

The CLIA number assigned to this NPI record is 10D2151726 - pharmacy with a certificate type of Certificate of Waiver.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

• Fee covid-19 vac 13 res (HCPCS:0124A)
• Adm sarscov2 30mcg/0.3ml bst (HCPCS:0004A)
• Administration of influenza virus vaccine (HCPCS:G0008)
• Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage (HCPCS:90694)

The enumeration date for this NPI number is 7/18/2018 and was last updated on 7/18/2018.

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: