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IMA DEGNAN DISPENSARY
NPI 1700315991
Non-Pharmacy Dispensing Site in Davenport, FL

Active since June 09, 2017CLIA 10D0968096 · Waiver
181 WEBB DR, DAVENPORT, FL 33837(863) 419-1235(863) 419-9525 Get Directions Write a Review

NPPES record last updated: June 9, 2017. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Ima Degnan Dispensary NPPES

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

IMA DEGNAN DISPENSARY (NPI 1700315991) is a healthcare organization registered as a non-pharmacy dispensing site in Davenport, Florida and active in the NPI registry since June 2017. The organization holds a CLIA Waiver certificate valid through February 16, 2028 and lists Patricia Pichardo, Coo, as its authorized official.

NPPES Registry Identity

NPI1700315991
Entity TypeOrganization
Primary Taxonomy332900000X
Legal Business NameMEDICAL HOME ALLIANCE LLC
Location Address181 WEBB DRDavenport, FL 33837-3964
Mailing Address6675 Westwood Blvd Ste 475Orlando, FL 32821-6027 · (407) 845-0330 · Fax (888) 972-1752
Phone(863) 419-1235
Fax(863) 419-9525
Organization SubpartYesParent: Inhealth Md Alliance
Authorized OfficialPatricia PichardoCoo · (407) 845-0333
Enumeration DateJune 9, 2017
✔ NPI 1700315991 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNon-Pharmacy Dispensing SiteSuppliers
Taxonomy Code332900000X
Definition
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.)
181 WEBB DR, Davenport, FL 33837
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Other Names 1

Doing Business AsIma Degnan Dispensary

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D0968096

Medical Home Alliance, LLC Dba Ima Medical Group · Davenport, FL
Active · expires Feb 16, 2028
CLIA Number10D0968096
Laboratory TypePhysician Office
Certificate Effective DateFebruary 17, 2026
Certificate Expiration DateFebruary 16, 2028
Laboratory DirectorIsmael Ruiz De La Rosa
Laboratory Phone(863) 419-1235
Laboratory LocationMedical Home Alliance, LLC Dba Ima Medical Group181 Webb Dr Ste A, Davenport, FL 33837
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

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

MICHAEL G. DEGNAN, LLC
Family Medicine
181 WEBB DR, SUITE A
DAVENPORT, FL 33837
Polk County (863) 419-1235
MEDICAL HOME ALLIANCE LLC
Internal Medicine
181 WEBB DR
DAVENPORT, FL 33837
Polk County (863) 419-1235
DR. MICHAEL G. DEGNAN M.D.
Family Medicine
181 WEBB DR, STE B
DAVENPORT, FL 33837
Polk County (863) 419-1235

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 Medical Home Alliance LLC's NPI number?

The NPI number for Medical Home Alliance LLC is 1700315991. It was assigned to this organization in the NPPES registry on June 9, 2017. The provider is doing business as Ima Degnan Dispensary.

Where is Medical Home Alliance LLC located?

Medical Home Alliance LLC is located at 181 Webb Dr, Davenport, FL 33837. The listed phone number is (863) 419-1235.

What is Medical Home Alliance LLC's specialty?

The primary specialty registered for this NPI is Non-Pharmacy Dispensing Site with taxonomy code 332900000X.

Does Medical Home Alliance LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D0968096) is associated with this NPI, valid through February 16, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Medical Home Alliance LLC was last updated on June 9, 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.