Organization · Type 2 NPI

Brevard Family Walk In Clinic LLC

Non-Pharmacy Dispensing Site · Merritt Island, FL

NPI number 1881008696 Active

Practice location

1205 N Courtenay Pkwy
Merritt Island, FL 32953-5500

Call (321) 636-0005 Map

Mailing address

5626 Oberlin Dr, Suite 110
San Diego, CA 92121-1705

Specialties and licenses

Taxonomy	Code	License
Non-Pharmacy Dispensing Site Primary	332900000X	ME86649 (FL)

Non-Pharmacy Dispensing Site: A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)

3 other providers at this address

Other non-pharmacy dispensing site providers in Merritt Island

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NPI record

NPI: 1881008696
Entity type: Organization (Type 2)
Issued: Jun 19, 2014
Last updated: Jun 19, 2014
Status: Active
Subpart: Yes of Medvantx, Inc.

Other names

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Brevard Family Walk In Clinic Merritt Island · doing business as

Authorized official

Kenny Heine
VP of Operations
(858) 964-1506

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1881008696

Brevard Family Walk In Clinic LLC's National Provider Identifier is 1881008696, issued on Jun 19, 2014. The primary taxonomy on file is Non-Pharmacy Dispensing Site (332900000X), and the practice location is in Merritt Island, FL. The record was last updated on Jun 19, 2014.