SPACE COAST COMMUNITY PHARMACY
NPI 1851750178
Pharmacy - Community/Retail Pharmacy in Rockledge, FL
NPI Status: Active since February 15, 2016
Contact Information
197 BOUGAINVILLEA DR STE D
ROCKLEDGE, FL
ZIP 32955
Phone: (321) 636-2275
- Organization
- Pharmacy
- Community/Retail Pharmacy
- Accepts Insurance
- CLIA Number: 10D2189527
- CLIA Cert. Type: Pharmacy
- CLIA Exp. Date: 07-31-2026
About SPACE COAST COMMUNITY PHARMACY
This page provides the complete NPI Profile along with additional information for Space Coast Community Pharmacy, a provider established in Rockledge, Florida operating as a Pharmacy, focusing in community/retail pharmacy . The healthcare provider is registered in the NPI registry with number 1851750178 assigned on February 2016. The practitioner's primary taxonomy code is 3336C0003X with license number PH29873 (FL). The provider is registered as an organization and their NPI record was last updated 6 years ago. The provider's is doing business as Space Coast Community Pharmacy. The authorized official of this NPI record is Traci Mitchell (Owner)
- NPI
- 1851750178
- Provider Legal Name
- CRAYTON MITCHELL GROUP
- Other Organization Name
- SPACE COAST COMMUNITY PHARMACY
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 197 BOUGAINVILLEA DR STE D ROCKLEDGE, FL 32955
- Location Phone
- (321) 636-2275
- Mailing Address
- 197 BOUGAINVILLEA DR STE D ROCKLEDGE, FL 32955
- Mailing Phone
- (321) 636-2275
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 02-15-2016
- Last Update Date
- 01-28-2020
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Pharmacy Community/Retail Pharmacy
- Taxonomy Code
- 3336C0003X
- Type
- Suppliers
- License No.
- PH29873
- License State
- FL
- Taxonomy Description
- 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.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 332B00000X | Suppliers | Durable Medical Equipment & Medical Supplies | PH29873 (FL) |
| 2 | 332BC3200X | Suppliers | Durable Medical Equipment & Medical Supplies | PH29873 (FL) |
| 3 | 333600000X | Suppliers | Pharmacy |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Bronze 1826 ($0 Medical Deductible, $0 Primary Care Copay- Visits 1 & 2, Specialist & Urgent Care Copay, Open Access) - HMO
- Bronze 1826 + Adult Dental + Adult Vision ($0 Medical Deductible, $0 Primary Care Copay- Visits 1 & 2, Specialist & Urgent Care Copay, Open Access) - HMO
- Bronze Savings 1820 (Primary Care Copay Visits 1-5, Open Access) - HMO
- Bronze Savings 1820 + Adult Dental + Adult Vision (Primary Care Copay Visits 1-5, Open Access) - HMO
- Bronze Standard 1828 - HMO
- Bronze Value 1814 (High Value Network Savings, Open Access) - HMO
- Bronze Value 1814 + Adult Dental + Adult Vision (High Value Network Savings, Open Access) - HMO
- Catastrophic 1746 (Primary Care Copay Visits 1-3, Open Access) - HMO
- Gold 1742 (Emergency Room & Inpatient Hospitalization Copay, $0 Outpatient Labs, $0 MRI, Open Access) - HMO
- Gold 1742 + Adult Dental + Adult Vision (Emergency Room & Inpatient Hospitalization Copay, $0 Outpatient Labs, $0 MRI, Open Access) - HMO
- Humana Dental Smart Choice - PPO
- Humana Dental Smart Choice - High - PPO
- Humana Dental Smart Choice - Lite - PPO
- Humana Dental Smart Choice - Low - PPO
- Balance by Medica Bronze $0 Copay PCP Visits - EPO
- Balance by Medica Bronze Premier - EPO
- Balance by Medica Expanded Bronze Standard - EPO
- Balance by Medica Gold $0 Copay PCP Visits - EPO
- Balance by Medica Gold Share - EPO
- Balance by Medica Gold Standard - EPO
- Balance by Medica Silver $0 Copay PCP Visits - EPO
- Balance by Medica Silver Share - EPO
- Balance by Medica Silver Standard - EPO
- Medica with MU Health Care Bronze $0 Copay PCP Visits - EPO
- Moda Health Affinity Bronze 8000 - EPO
- Moda Health Affinity Bronze 9000 - EPO
- Moda Health Affinity Bronze HDHP 7500 - EPO
- Moda Health Affinity Gold 1000 - EPO
- Moda Health Affinity Gold 1500 - EPO
- Moda Health Affinity Gold 250 - EPO
- Moda Health Affinity Silver 3000 - EPO
- Moda Health Affinity Silver 3400 - EPO
- Moda Health Affinity Silver 4500 - EPO
- Moda Health Affinity Silver 6000 - EPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 2158119 | OTHER (01) | PK |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 10D2189527
- Facility Type
- Pharmacy
- Certificate Effective Date
- August 01, 2024
- Certificate Expiration Date
- July 31, 2026
- Laboratory Director
- TRACI J. MITCHELL
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Space Coast Community Pharmacy to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1851750178, we treat the final digit (8) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 52. The final step is to find the difference between that total and the next multiple of ten (60 - 52 = 8).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 52 is 60. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1851750178, enumerated as an "organization" on February 15, 2016.
The provider is located at 197 BOUGAINVILLEA DR STE D ROCKLEDGE, FL 32955 and the phone number is (321) 636-2275.
Pharmacy with taxonomy code 3336C0003X and a focus in Community/Retail Pharmacy.
The provider might be accepting Accepts: Health First Commercial Plans, Inc., Humana,. Please consult your insurance carrier or call the provider to verify.
