Provider Demographics
NPI:1972515757
Name:CHELSEA DISCOUNT APOTHECARY INC
Entity type:Organization
Organization Name:CHELSEA DISCOUNT APOTHECARY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:JEFFREY
Authorized Official - Last Name:HONEA
Authorized Official - Suffix:SR
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:850-858-0212
Mailing Address - Street 1:312 NEW WARRINGTON ROAD
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32506-5855
Mailing Address - Country:US
Mailing Address - Phone:850-475-7091
Mailing Address - Fax:850-858-0215
Practice Address - Street 1:312 NEW WARRINGTON ROAD
Practice Address - Street 2:SUITE 2A
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32506-5855
Practice Address - Country:US
Practice Address - Phone:850-475-7091
Practice Address - Fax:850-858-0215
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHELSEA DISCOUNT APOTHECARY INC DBA CONCERN CARE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-12
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 3336M0002X
FLPH229533336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336M0002XSuppliersPharmacyMail Order Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL030885400Medicaid
1012260OtherOTHER ID NUMBER