MR. SIMON B VAN WAGENEN RPH
NPI 1790816072
Pharmacist in Starke, FL

Active since March 08, 2007
470 W MADISON ST, STARKE, FL 32091(904) 964-6759(904) 964-5315 Get Directions Write a Review

NPPES record last updated: July 9, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mr. Simon B Van Wagenen Rph NPPES

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

MR. SIMON B VAN WAGENEN RPH (NPI 1790816072) is an individual pharmacist in Starke, Florida, licensed in Florida (PS16532) and active in the NPI registry since March 2007.

NPPES Registry Identity

NPI1790816072
Entity TypeIndividualMale
Primary Taxonomy183500000X
Provider Legal NameMR. SIMON B VAN WAGENENCredential: RPH
Location Address470 W MADISON STStarke, FL 32091-3926
Mailing Address15604 Sw 161st StBrooker, FL 32622-2540 · (904) 449-3937 · Fax (904) 964-5315
Fax(904) 964-5315
Sole ProprietorNo
Enumeration DateMarch 8, 2007
Last NPPES UpdateJuly 9, 2007
NPI 1790816072 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPharmacistPharmacy Service Providers
Taxonomy Code183500000X
License Licensed in FL · PS16532
Definition
An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.
470 W MADISON ST, Starke, FL 32091

Other Providers at the Same Location NPPES

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

Pharmacist
470 W MADISON ST
STARKE, FL 32091

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 Simon Van Wagenen's NPI number?

The NPI number for Simon Van Wagenen is 1790816072. It was assigned to this individual provider in the NPPES registry on March 8, 2007.

Where is Simon Van Wagenen located?

Simon Van Wagenen practices at 470 W Madison St, Starke, FL 32091. The listed phone number is (904) 964-6759.

What is Simon Van Wagenen's specialty?

The primary specialty registered for this NPI is Pharmacist with taxonomy code 183500000X.

When was this NPI record last updated?

The NPPES record for Simon Van Wagenen was last updated on July 9, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.