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CRESTVIEW PHARMACY, LLC
NPI 1407965262
Pharmacy - Community/Retail Pharmacy in Crestview, FL

Active since August 29, 2006
1116 N FERDON BLVD, CRESTVIEW, FL 32536(850) 683-1111(850) 683-1753 Get Directions Write a Review

NPPES record last updated: June 11, 2019. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jun 11, 2019, Apr 29, 2019 (2 updates tracked since 2019).

About Crestview Pharmacy, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CRESTVIEW PHARMACY, LLC (NPI 1407965262), doing business as Crestview Pharmacy, Inc, is a healthcare organization registered as a community/retail pharmacy in Crestview, Florida and active in the NPI registry since August 2006. The organization lists Vince Dagrava, Coo, as its authorized official.

NPPES Registry Identity

NPI1407965262
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameCRESTVIEW PHARMACY, LLC
Location Address1116 N FERDON BLVDCrestview, FL 32536-1710
Mailing Address1116 N Ferdon BlvdCrestview, FL 32536-1710 · (850) 683-1111 · Fax (850) 683-1753
Phone(850) 683-1111
Fax(850) 683-1753
Organization SubpartNo
Authorized OfficialVince DagravaCoo · (859) 552-5013
Enumeration DateAugust 29, 2006
Last NPPES UpdateJune 11, 20192 updates tracked since enumeration
✔ NPI 1407965262 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License✔ Licensed in FL · PH18397
Definition
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.
1116 N FERDON BLVD, Crestview, FL 32536
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Other Names 1

Former Legal Business NameCrestview Pharmacy, Inc

Other Identifiers 3

Medicaid025327800FL
Other1094870FL · Ncpdp - Napb
Medicaid100200027AL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc..Insurance ›

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EMILY CLAIRE BLACKMON
Pharmacist
1116 N FERDON BLVD
CRESTVIEW, FL 32536
Okaloosa County (850) 683-1111
DR. MELVIN DOUGLAS LIVINGSTON JR. PHARMACIST
Pharmacist
1116 N FERDON BLVD
CRESTVIEW, FL 32536
Okaloosa County (850) 902-0206
DR. HAL J. DENSMAN PHARMD
Pharmacist
1116 N FERDON BLVD
CRESTVIEW, FL 32536
Okaloosa County (850) 683-1111
JENNIFER RESHAY WOOD PHARMD
Pharmacist
1116 N FERDON BLVD
CRESTVIEW, FL 32536
Okaloosa County (850) 683-1111

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Crestview Pharmacy, LLC's NPI number?

The NPI number for Crestview Pharmacy, LLC is 1407965262. It was assigned to this organization in the NPPES registry on August 29, 2006. The provider was formerly known as Crestview Pharmacy, Inc.

Where is Crestview Pharmacy, LLC located?

Crestview Pharmacy, LLC is located at 1116 N Ferdon Blvd, Crestview, FL 32536. The listed phone number is (850) 683-1111.

What is Crestview Pharmacy, LLC's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

What insurance does Crestview Pharmacy, LLC accept?

Health plans from Moda Health Plan, Inc. list Crestview Pharmacy, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Crestview Pharmacy, LLC was last updated on June 11, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.