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MACK BAYOU PHARMACY LLC
NPI 1508112889
Pharmacy - Compounding Pharmacy in Santa Rosa Beach, FL

Active since July 24, 2012
82 MACK BAYOU LOOP STE B, SANTA ROSA BEACH, FL 32459(850) 622-0730(850) 622-0755 Get Directions Write a Review

NPPES record last updated: March 1, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 1, 2017, Jan 18, 2017 (2 updates tracked since 2017).

About Mack Bayou Pharmacy Llc NPPES

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

MACK BAYOU PHARMACY LLC (NPI 1508112889) is a healthcare organization registered as a compounding pharmacy in Santa Rosa Beach, Florida and active in the NPI registry since July 2012. The organization lists Amy Frazier, Owner, as its authorized official.

NPPES Registry Identity

NPI1508112889
Entity TypeOrganization
Primary Taxonomy3336C0004X
Legal Business NameMACK BAYOU PHARMACY LLC
Location Address82 MACK BAYOU LOOP STE BSanta Rosa Beach, FL 32459-2607
Mailing Address82 Mack Bayou Loop Ste BSanta Rosa Beach, FL 32459-2607 · (850) 622-0730 · Fax (850) 622-0755
Phone(850) 622-0730
Fax(850) 622-0755
Organization SubpartNo
Authorized OfficialAmy FrazierOwner · (850) 622-0730
Enumeration DateJuly 24, 2012
Last NPPES UpdateMarch 1, 20172 updates tracked since enumeration
✔ NPI 1508112889 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacy · Compounding PharmacySuppliers
Taxonomy Code3336C0004X
License✔ Licensed in FL · PH26321
Definition
A pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner's Prescription Drug Order or initiative based on the Practitioner/Patient/Pharmacist relationship in the course of professional practice. A compounding pharmacy utilizes specialized equipment and specially designed facilities necessary to meet the legal and quality requirements of its scope of compounding practice.
Also ListedPharmacyTaxonomy 333600000X
Also ListedPharmacy · Community/Retail PharmacyTaxonomy 3336C0003X
82 MACK BAYOU LOOP STE B, Santa Rosa Beach, FL 32459
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Other Names 1

Doing Business AsMack Bayou Pharmacy Llc

Other Identifiers 1

Other2137562Pk

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AvMed, Blue Cross and Blue Shield of Kansas City, HealthPartners and more.Insurance ›

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 Mack Bayou Pharmacy LLC's NPI number?

The NPI number for Mack Bayou Pharmacy LLC is 1508112889. It was assigned to this organization in the NPPES registry on July 24, 2012.

Where is Mack Bayou Pharmacy LLC located?

Mack Bayou Pharmacy LLC is located at 82 Mack Bayou Loop Ste B, Santa Rosa Beach, FL 32459. The listed phone number is (850) 622-0730.

What is Mack Bayou Pharmacy LLC's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Compounding Pharmacy, with taxonomy code 3336C0004X.

What insurance does Mack Bayou Pharmacy LLC accept?

Health plans from AvMed, Blue Cross and Blue Shield of Kansas City, HealthPartners, Highmark Blue Cross Blue Shield Delaware and Highmark Blue Cross Blue Shield West Virginia and 4 other insurers list Mack Bayou 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 Mack Bayou Pharmacy LLC was last updated on March 1, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.