ANCLAJE ONDUlADO
SEGUIMIENTO Y CORRECCIÓN DE DEFORMACIONES
Provider Medicaid ID
License
Number Provider Name Doing Business As Name Street_1 Street_2 City State
Zip
Code County
109012701 1312221 AMERICAN HOME PATIENT 7170 N 9TH AVE PENSACOLA FL 32504 ESCAMBIA
022780301 ANDERSON'S THRIF-T DRUGS, INC. 14 WEST JORDAN STREET PENSACOLA FL 32501 ESCAMBIA
022781101 ANDERSON'S THRIF-T DRUGS, INC. MARKET PLACE 4350 BAYOU BLVD STE 5 PENSACOLA FL 32503 ESCAMBIA
950254814 HM0000674 APRIA HEALTHCARE 3636D N L ST STE B PENSACOLA FL 32505 ESCAMBIA
031884101 DURA-MED SOUTHEAST INC 174 HWY 113 FLOMATON AL 36441 ESCAMBIA
027400300 HM0000129 GILLETTE WHEELCHAIR ENGINEERS, INC 3936 NORTH DAVIS HWY PENSACOLA FL 32503 ESCAMBIA
101190101 A & E PHARMACY INC DAVID ENFINGER 923 NEW WARRINGTON RD PENSACOLA FL 32506 ESCAMBIA 25259000 283 ABLE MEDICAL & SICKROOM SUPPLIES 2475 E NINE MILES ROAD SUITE H PENSACOLA FL 32514 ESCAMBIA 32143501 AMBIENT HEALTHCARE OF WEST FLORIDA AMBIENT HEALTHCARE 213 E WRIGHT ST PENSACOLA FL 32501 ESCAMBIA 109012701 AMERICAN HOME PATIENT 7170 N 9TH AVE PENSACOLA FL 32504 ESCAMBIA 2047400 12357 BAPTIST HOSPITAL, INC
BAPTIST HOME HEALTH CARE MEDICAL EQUIPMENT AND SUP
1901 N E ST PENSACOLA FL 32501 ESCAMBIA
3194800 1313544 BARNES HEATLH CARE OF FLORIDA BARNES HEALTH CARE 4081 E OLIVE RD STE L PENSACOLA FL 32514 ESCAMBIA 105463501 BIG B DRUGS, INC. CVS PHARMACY 4027 8361 N CENTURY BLVD CENTURY FL 32535 ESCAMBIA 105477501 BIG B DRUGS, INC. CVS PHARMACY 4171 1001 SCENIC HWY PENSACOLA FL 32503 ESCAMBIA 105488101 BIG B DRUGS, INC. CVS PHARMACY 4177 2100 W CERVANTES ST PENSACOLA FL 32505 ESCAMBIA 102398501 CANTONMENT PHARMACY 433 HWY. 29 SOUTH CANTONMENT FL 32533 ESCAMBIA 106614501 PH0016516 CENTURY PHARMACY 7531 MAYO STREET CENTURY FL 32535 ESCAMBIA 3410901 CORAM ALTERNATE SITE SERVICES, INC. CORAM SPECIALTY INFUSION
SERVICES, AN APRIA HEALTH 3439 N 12TH AVE STE A AND B PENSACOLA FL 32503 ESCAMBIA 100993101 DRUG SHOP INC P.O. BOX 2217 PENSACOLA FL 32503 ESCAMBIA 21467101 ENSLEY PHARMACY 8814-C OLD PALAFOX STREET PENSACOLA FL 32534 ESCAMBIA 105010901 FIRESIDE PHARMACY 5507 NORTH "W" STREET PENSACOLA FL 32505 ESCAMBIA 25910100 ORF22 FITTING DESIGNS, INC 8800 UNIVERSITY PKWY SUITE B-1 PENSACOLA FL 32514 ESCAMBIA 6901600 GILG PROSTETHETICS INC GILG PROSTETHETICS INC 87 W HOOD DR PENSACOLA FL 32534 ESCAMBIA 21575900 PR0000026 GILG PROSTHETICS, INC. 87 WEST HOOD DRIVE PENSACOLA FL 32534 ESCAMBIA 27400300 HM0000129 GILLETTE WHEELCHAIR ENGINEERS,INC 3936 N. DAVIS HWY PENSACOLA FL 32503 ESCAMBIA 32522800 1313487 GRACE MEDICAL INC GRACE HEALTHCARE 3357 COPTER RD STE 1 PENSACOLA FL 32514 ESCAMBIA 26433401 GULF MEDICAL SERVICES, INC GULF MEDICAL VITAL CARE 3103 N 12TH AVE PENSACOLA FL 32503 ESCAMBIA 27405400 HM0000112 GULF MEDICAL SVC., INC. 3103 N. 12TH AVE PENSACOLA FL 32503 ESCAMBIA 951893201 HANGER PROSTHETICS & ORTHOTICS,INC 2521-C CREIGHTON RD PENSACOLA FL 32504 ESCAMBIA 2006401 PH0024579 HOLIDAY CVS L.L.C. CVS PHARMACY# 05832 1521 NW 13TH ST GAINESVILLE FL 32601 ESCAMBIA 105868101 HOLIDAY CVS, LLC CVS PHARMACY 03283 6859 N 9TH AVE PENSACOLA FL 32504 ESCAMBIA 105766901 HOLIDAY CVS, LLC CVS PHARMACY 03675 1 E NINE MILE RD PENSACOLA FL 32534 ESCAMBIA 105556901 HOLIDAY CVS, LLC CVS PHARMACY 04430 400 N NAVY BLVD PENSACOLA FL 32507 ESCAMBIA 105560701 HOLIDAY CVS, LLC CVS PHARMACY 04458 8150 N DAVIS HWY PENSACOLA FL 32514 ESCAMBIA 105561501 HOLIDAY CVS, LLC CVS PHARMACY 04461 8187 W FAIRFIELD DR DW PENSACOLA FL 32506 ESCAMBIA 106163101 HOLIDAY CVS, LLC CVS PHARMACY 05158 5301 N PALAFOX ST PENSACOLA FL 32505 ESCAMBIA
Provider Medicaid ID
License
Number Provider Name Doing Business As Name Street_1 Street_2 City State
Zip
Code County
106364201 HOLIDAY CVS, LLC CVS PHARMACY 05175 13390 PERDIDO KEY DR PENSACOLA FL 32507 ESCAMBIA 106355301 HOLIDAY CVS, LLC CVS PHARMACY 05179 3880 N 9TH AVE PENSACOLA FL 32503 ESCAMBIA 106359601 HOLIDAY CVS, LLC CVS PHARMACY 05180 4500 SAUFLEY FIELD RD PENSACOLA FL 32526 ESCAMBIA 28198101 HOLIDAY CVS, LLC. 2090 S HIGHWAY 29 CANTONMENT FL 32533 ESCAMBIA 101036102 JACKSON STEVEN L JACKSON-PACE PHARMACY 2256 W NINE MILE RD PENSACOLA FL 32534 ESCAMBIA 3114001 PH25080 JOSEPH'S PHARMACY LLC 3130 N PACE BLVD PENSACOLA FL 32505 ESCAMBIA 32374801 PH0022889 JUNIOR FOOD STORES OF WEST FLORIDA, INC. KROGER PHARMACY 2990 SOUTH BLUE ANGEL PARKWAY PENSACOLA FL 32506 ESCAMBIA 101873601 K MART PHARMACY #4122 4211 MOBILE HWY PENSACOLA FL 32506 ESCAMBIA 101183901 K MART PHARMACY #4723 1650 AIRPORT BLVD. PENSACOLA FL 32504 ESCAMBIA 100724601 K MART PHARMACY #9714 NORTHVIEW SHOPPING CTR. 235 E NINE MILE RD PENSACOLA FL 32534 ESCAMBIA 31103101 KIM'S FAMILY PHARMACY, INC. 740 HIGHWAY 29 NORTH CANTONMENT FL 32533 ESCAMBIA 21728001 LANDMARK DRUGS, INC. PFEIFFERS DRUGS 2501 W CERVANTES ST PENSACOLA FL 32505 ESCAMBIA 31910400 97 LINCARE, INC 3700 CREIGHTON RD STE 9 PENSACOLA FL 32504 ESCAMBIA 950809100 HM0000094 M*A*S*H* INC 5800 NORTH W STREET 5 PENSACOLA FL 32505 ESCAMBIA 302200 1313455 MEDICAL SERVICES OF AMERICA INC MEDI HOME CARE 2411 EXECUTIVE PLAZA RD PENSACOLA FL 32504 ESCAMBIA 2932000 ORT000017 PENSACOLA ORTHOTIC & PROSTHETIC
SPECIALTIES, INC
PENSACOLA ORTHOTIC & PROSTHETIC SPECIALTIES, INC
5855 CREEK STATION DR PENSACOLA FL 32504 ESCAMBIA 2681100 POR145 PERFORMANCE PROSTHETICS & ORTHOTICS 2280 N 9TH AVE PENSACOLA FL 32503 ESCAMBIA 783001 PUBLIX SUPER MARKETS, INC PUBLIX PHARMACY #1343 2180 W NINE MILE RD PENSACOLA FL 32534 ESCAMBIA 1885501 PH0024293 PUBLIX SUPER MARKETS, INC PUBLIX PHARMACY #1316 5055 N 9TH AVE PENSACOLA FL 32504 ESCAMBIA 2670001 PH0024774 PUBLIX SUPER MARKETS, INC. PUBLIX PHARMACY #1296 13390 PERDIDO KEY DRIVE PENSACOLA FL 32507 ESCAMBIA 1742301 PUBLIX SUPER MARKETS, INC. PUBLIX PHARMACY #1318 5998 MOBILE HWY PENSACOLA FL 32526 ESCAMBIA 664701 PH0023622 PUBLIX SUPER MARKETS, INC. PUBLIX PHARMACY 1317 9251 UNIVERSITY PKWY PENSACOLA FL 32514 ESCAMBIA 32608900 1313395 RESPIRATORY CONSULTANTS, INC 450 VAN PELT LANE PENSACOLA FL 32505 ESCAMBIA 21659300 HM0000337 ROTECH OXYGEN & MED EQUIPMENT, INC PFEIFFER MEDICAL EQUIPMENT 1211 CREIGHTON RD PENSACOLA FL 32504 ESCAMBIA 21966501 RX ADVANTAGE, INC. 2256-B WEST NINE MILE ROAD PENSACOLA FL 32534 ESCAMBIA 103353101 PH0009498 SACRED HEART HOSPITAL OF PENSACOLA SUITE 205 5149 N 9TH AVE PENSACOLA FL 32504 ESCAMBIA 25451701 SAM'S EAST INC SAM'S PHARMACY 10-8119 1250 AIRPORT BLVD PENSACOLA FL 32504 ESCAMBIA 22416201 PH0017514 SCOTT'S PHARMACY 6505 HWY 29 NORTH MOLINO FL 32577 ESCAMBIA 851001 TARGET CORPORATION TARGET STORE T-2445 2950 S BLUE ANGEL PKWY PENSACOLA FL 32506 ESCAMBIA 101363701 TARGET CORPORATION TARGET STORE T-0686 4711 BAYOU BLVD PENSACOLA FL 32503 ESCAMBIA 22245301 TARGET CORPORATION TARGET STORE T-1273 1749 E NINE MILE RD PENSACOLA FL 32514 ESCAMBIA 104267001 THE TOWERS PHARMACY, INC. 1717 N "E" ST SUITE 102 PENSACOLA FL 32501 ESCAMBIA 22025601 TWIN TOWERS PHARMACY BAPTIST MEDICAL PARK PHRMCY 9400 UNIVERSITY PKWY PENSACOLA FL 32514 ESCAMBIA 26410500 VERHI, INC GULF COAST ORTHOTICS & PROST 824 CREIGHTON RD PENSACOLA FL 32504 ESCAMBIA 587701 PH0023750 WALGREEN CO WALGREENS 13072 8333 N DAVIS HWY STE 50 PENSACOLA FL 32514 ESCAMBIA 28310001 PH0021041 WALGREEN CO WALGREEN 01222 20 W NINE MILE RD PENSACOLA FL 32534 ESCAMBIA 22980601 WALGREEN CO WALGREEN 05659 870 E CERVANTES ST PENSACOLA FL 32501 ESCAMBIA 26224201 WALGREEN CO WALGREEN 07344 700 N PACE BLVD PENSACOLA FL 32505 ESCAMBIA
Provider Medicaid ID
License
Number Provider Name Doing Business As Name Street_1 Street_2 City State
Zip
Code County
26914001 WALGREEN CO WALGREEN 07650 1909 E NINE MILE RD PENSACOLA FL 32514 ESCAMBIA 31643101 WALGREEN CO WALGREENS 09916 1841 E OLIVE RD PENSACOLA FL 32514 ESCAMBIA 31991101 WALGREEN CO WALGREENS 09917 5995 MOBILE HWY PENSACOLA FL 32526 ESCAMBIA 31948101 WALGREEN CO WALGREENS 10181 2237 W NINE MILE RD PENSACOLA FL 32534 ESCAMBIA 32074901 WALGREEN CO WALGREENS 10312 85 BEVERLY PKWY PENSACOLA FL 32505 ESCAMBIA 32587201 WALGREEN CO. WALGREENS 01042 4497 MOBILE HWY PENSACOLA FL 32506 ESCAMBIA 22295001 WALGREEN CORPORATION WALGREEN 05581 6314 N 9TH AVE PENSACOLA FL 32504 ESCAMBIA 100415801 WAL-MART #10-1222 8970 PENSACOLA BLVD. PENSACOLA FL 32514 ESCAMBIA 109977901 WAL-MART #10-1224 2650 CREIGHTON RD. PENSACOLA FL 32504 ESCAMBIA 101027101 WAL-MART PHARMACY 10-1605 4600 MOBILE HWY. SUITE 122 PENSACOLA FL 32506 ESCAMBIA 25449501 WAL-MART STORES EAST LP WAL-MART PHARMACY 10-3484 2951 S BLUE ANGEL PKWY PENSACOLA FL 32506 ESCAMBIA 31786101 WAL-MART STORES EAST, LP WAL-MART PHARMACY 10-3785 501 N NAVY BLVD PENSACOLA FL 32507 ESCAMBIA 26484901 WINN DIXIE MONTGOMERY, INC WINN DIXIE PHARMACY 493 13019 SORRENTO RD PENSACOLA FL 32507 ESCAMBIA 25617001 WINN DIXIE PHARMACY #504 WINN DIXIE MONTGOMERY, INC 7135 N 9TH AVE PENSACOLA FL 32504 ESCAMBIA 101249501 WINN DIXIE PHARMACY 556 4751 BAYOU BLVD. PENSACOLA FL 32503 ESCAMBIA 106536001 WINN-DIXIE #535 WINN-DIXIE INC 50 S BLUE ANGEL PKWY PENSACOLA FL 32506 ESCAMBIA 220007401 WINN-DIXIE MONTGOMERY, INC. WINN-DIXIE PHARMACY 506 312 E NINE MILE RD PENSACOLA FL 32514 ESCAMBIA 106281601 WINN-DIXIE PHARMACY #2244 WINN-DIXIE STORES INC. 111 FLAGLER PLAZA DR PALM COAST FL 32137 ESCAMBIA 106600501 WINN-DIXIE PHARMACY #495 5975 MOBILE HWY PENSACOLA FL 32526 ESCAMBIA
97 ADULT AND PEDIATRIC SPECIALISTS 3700 CREIGHTON RD STE 9 PENSACOLA FL 32504 ESCAMBIA
1312221 AMERICAN HOMEPATIENT 7170 N 9TH AVE PENSACOLA FL 32504 ESCAMBIA
1313300 B & B MEDICAL SERVICES INC 3899 NORTH W STE 43 PENSACOLA FL 32505 ESCAMBIA
1313544 BARNES HEALTHCARE OF FLORIDA LLC 124 INDUSTRIAL BLVD PENSACOLA FL 32505 ESCAMBIA
112 GULF MEDICAL SERVICES INC 3103 N 12TH AVENUE PENSACOLA FL 32503 ESCAMBIA
1312983 HYGEIA MEDICAL EQUIPMENT LLC 2 N PALAFOX ST STE 201 PENSACOLA FL 32502 ESCAMBIA
1313427 KCI USA INC 9900 F N PALAFOX ST PENSACOLA FL 32534 ESCAMBIA
1313529 LIFEGAS 3179 GATEWAY LN CANTONMENT FL 32533 ESCAMBIA
1313455 MEDI HOME CARE 2411 EXECUTIVE PLAZA RD PENSACOLA FL 32504 ESCAMBIA
337 PFEIFFER MEDICAL EQUIPMENT 1211 CREIGHTON RD PENSACOLA FL 32504 ESCAMBIA
283 SWEETWATER MEDICAL WEST 2475 E NINE MILE RD STE H PENSACOLA FL 32514 ESCAMBIA
030829309 BARNES HEALTHCARE OF FLORIDA LLC 2207 S. FREEDOM BLVD CRESTVIEW FL 32530 OKALOOSA
002027600 1312932 BARNES HEALTHCARE OF FLORIDA, LLC BARNES HEALTHCARE 2207 S. FERDON BLVD CRESTVIEW FL 32539 OKALOOSA
028315100 1593 GULF MEDICAL SERVICES INC 320 RACETRACK RD NE FT WALTON BEACH FL 32547 OKALOOSA
27468200 1312665 AMERICAN HOME PATIENT 115 F RACETRACK RD NW FT. WALTON BEACH FL 32547 OKALOOSA 105474101 BIG B DRUGS, INC. CVS PHARMACY 4015 302 E JAMES LEE BLVD CRESTVIEW FL 32539 OKALOOSA 32149400 OR00000156 CREATIVE ORTHOTIC & PROSTHETIC SER 120 E REDSTONE AVE STE C CRESTVIEW FL 32539 OKALOOSA 25327801 CRESTVIEW PHARMACY INC. 1116 N. FERDON BLVD. CRESTVIEW FL 32536 OKALOOSA 105801101 CVS EGL 13TH SAINT CLOUD FL, L.L.C. CVS PHARMACY 03139 3441 13TH ST SAINT CLOUD FL 34769 OKALOOSA 105219501 GARRETT'S PHARMACY SERVICES, INC THE PRESCRIPTION SHOPPE 536 E 1ST AVE CRESTVIEW FL 32536 OKALOOSA 951893202 HANGER PROSTHETICS & ORTHOTICS,INC FORT WALTON ORTHOPEDIC, INC 28 PERRY AVE SE FORT WALTON BEACH FL 32548 OKALOOSA
Provider Medicaid ID
License
Number Provider Name Doing Business As Name Street_1 Street_2 City State
Zip
Code County
102978901 HEALTH-SMART PHARMACY 5809 HIGHWAY 189 NORTH BAKER FL 32531 OKALOOSA 21527901 HOLIDAY CVS, LLC CVS PHARMACY 05194 1081 BEAL PKWY NW FORT WALTON BEACH FL 32547 OKALOOSA 105558501 HOLIDAY CVS, LLC CVS PHARMACY 04440 434 RACETRACK RD NE FT WALTON BCH FL 32547 OKALOOSA 30807201 HOLIDAY CVS, LLC 60 SOUTH HOLIDAY ROAD MIRAMAC FL 32550 OKALOOSA 106280801 HOLIDAY CVS, LLC CVS PHARMACY 04612 4562 E HIGHWAY 20 NICEVILLE FL 32578 OKALOOSA 106248401 HOLIDAY CVS, LLC. CVS PHARMACY 03003 71 MARY ESTHER BLVD MARY ESTHER FL 32569 OKALOOSA 104436201 K MART PHARMACY #3223 200 IRWIN AVE NE FT WALTON BCH FL 32548 OKALOOSA 25919500 HM0001229 LINCARE 430 BRYN ATHYN BLVD STE 2 MARY ESTHER FL 32569 OKALOOSA 3047200 1313384 LINCARE INC HCS HEALTH CARE
SOLUTIONS 802 CCS ST FT WALTON BCH FL 32547 OKALOOSA
27450000 96 M.A.S.H. INC. 242 RACETRACK RD N.E. FT. WALTON BEACH FL 32547 OKALOOSA 27707000 HME93 M.A.S.H.,INC. 1505-B SOUTH FERDON BLVD CRESTVIEW FL 32536 OKALOOSA 103146501 MOULTONS PHARMACY 648 NORTH FERDON BLVD CRESTVIEW FL 32536 OKALOOSA 2345100 NATIONAL REHAB EQUIPMENT,INC 11 RACETRACK RD NE FORT WALTON BEACH FL 32547 OKALOOSA 26601901 PUBLIX SUPER MARKETS INC PUBLIX PHARMACY 0383 421 MARY ESTHER CUT OFF
NW FORT WALTON BEACH FL 32548 OKALOOSA 789801 PH0023723 PUBLIX SUPER MARKETS, INC PUBLIX PHARMACY #1303 610 EGLIN PKWY NE FORT WALTON BEACH FL 32547 OKALOOSA 25156901 PUBLIX SUPER MARKETS, INC. PUBLIX PHARMACY 0801 2250 S FERDON BLVD CRESTVIEW FL 32536 OKALOOSA 22825701 PUBLIX SUPER MARKETS, INC. PUBLIX PHARMACY 0766 251 MIRACLE STRIP PKWY SE FORT WALTON BEACH FL 32548 OKALOOSA 21834101 PUBLIX SUPERMARKETS, INC. PUBLIX PHARMACY 7677 4425 COMMONS DR E DESTIN FL 32541 OKALOOSA 26813501 SAMS EAST INC SAMS PHARMACY 10-6361 740 BEAL PKWY NW FORT WALTON BEACH FL 32547 OKALOOSA 31080801 TARGET CORPORATION TARGET STORE T-2085 853 HARBOR BLVD DESTIN FL 32541 OKALOOSA 103370101 TARGET CORPORATION TARGET STORE T-0740 650 MIRACLE STRIP PKWY MARY ESTHER FL 32569 OKALOOSA 25437101 WALGREEN CO WALGREEN 06811 2350 S FERDON BLVD CRESTVIEW FL 32536 OKALOOSA 25473801 WALGREEN CO WALGREEN 06578 977 HIGHWAY 98 E DESTIN FL 32541 OKALOOSA 22265801 WALGREEN CO WALGREEN 05582 825 BEAL PKWY NW FORT WALTON BEACH FL 32547 OKALOOSA 25600501 WALGREEN CO WALGREEN 06978 4582 E HIGHWAY 20 NICEVILLE FL 32578 OKALOOSA 106602101 PH0016383 WALGREEN CO. #4848 414 C MARY ESTHER CUTOFF NW FT. WALTON BCH FL 32548 OKALOOSA 106572601 PH0016368 WALGREEN CO.#04913 34909 EMERALD COAST PKWY DESTIN FL 32541 OKALOOSA 101769101 PH0009372 WAL-MART #10-0919 546 MARY ESTER CUTOFF FT. WALTON BEACH FL 32548 OKALOOSA 109366501 PH0009380 WAL-MART #10-0944 PHARMACY MANAGER 3351 S FERDON BLVD CRESTVIEW FL 32536 OKALOOSA 100824201 WAL-MART PHARMACY #10-1362 EMERALD COAST CENTER 15003 EMERALD COAST
PKWY DESTIN FL 32541 OKALOOSA 3180501 WAL-MART STORES EAST, LP WAL-MART PHARMACY 10-5848 1300 JOHN SIMS PKWY E NICEVILLE FL 32578 OKALOOSA 102784101 WINN DIXIE PHARMACY #541 798 BEAL PARKWAY FT WALTON BEACH FL 32547 OKALOOSA 101420001 PH11981 WINN DIXIE PHARMACY #551 4512 E HIGHWAY 20 NICEVILLE FL 32578 OKALOOSA 106270101 WINN-DIXIE #566 WINN-DIXIE INC. 99 EGLIN PKWY FORT WALTON BEACH FL 32548 OKALOOSA 106396101 WINN-DIXIE INC WINN-DIXIE 558 1326 N FERDON BLVD CRESTVIEW FL 32536 OKALOOSA 21941001 WINN-DIXIE MONTGOMERY, INC. WINN DIXIE PHARMACY 560 981 U.S. HIGHWAY 98 DESTIN FL 32541 OKALOOSA
1313194 AMERICAN HOMEPATIENT 115 F RACETRACK RD NW FORT WALTON BEACH FL 32547 OKALOOSA
Provider Medicaid ID
License
Number Provider Name Doing Business As Name Street_1 Street_2 City State
Zip
Code County
1604 J & B MEDICAL INC 540 E JOHN SIMS PKWY NICEVILLE FL 32578 OKALOOSA
1313836 MEDI HOME CARE 1982-D LEWIS TURNER BLVD STE 101 FORT WALTON BEACH FL 32547 OKALOOSA
1313709 RESPIRATORY SERVICES OF NORTHWEST
FLORIDA INC 502 E PINE AVE STE B CRESTVIEW FL 32539 OKALOOSA
1313083 SLEEPMED THERAPY SERVICES 907 MAR WALT DR STE 2022 FORT WALTON BEACH FL 32547 OKALOOSA
951087700 HM0000040 DURA-MED SOUTHEAST, INC. 5272 COMMERCE ST JAY FL 32565 SANTA ROSA
030877300 1312572 TRI-CITY HOME MEDICAL INC 3878 HIGHWAY 4 JAY FL 32565 SANTA ROSA
3512400 1312459 AABON HOME HEALTH CARE SUPPLY, INC 5201 DOGWOOD DR MILTON FL 32570 SANTA ROSA
105470801 BIG B DRUGS, INC. CVS PHARAMCY 4155 3359 GULF BREEZE PKWY GULF BREEZE FL 32563 SANTA ROSA 106315401 BURKLOW PHARMACY 4880 WOODBINE ROAD PACE FL 32571 SANTA ROSA 106357001 HOLIDAY CVS, LLC CVS PHARMACY 05176 713 GULF BREEZE PKWY GULF BREEZE FL 32561 SANTA ROSA 105559301 HOLIDAY CVS, LLC CVS PHARMACY 04449 6501 CAROLINE ST MILTON FL 32570 SANTA ROSA 106494101 HOLIDAY CVS, LLC CVS PHARMACY 05248 8422 NAVARRE PKWY NAVARRE FL 32566 SANTA ROSA 106358801 HOLIDAY CVS, LLC CVS PHARMACY 05178 1100 JOHN SIMS PKWY E NICEVILLE FL 32578 SANTA ROSA 106241701 HOLIDAY CVS, LLC CVS PHARMACY 05249 3888 HIGHWAY 90 PACE FL 32571 SANTA ROSA 101481102 JAY PHARMACY INC 200 COMMERCE ST JAY FL 32565 SANTA ROSA 102675501 K MART PHARMACY # 3975 KMART CORPORATION 6050 HIGHWAY 90 MILTON FL 32570 SANTA ROSA 27740101 HM0001230 LINCARE INC-PENSACOLA 5700 N DAVIS HWY/ 6 PENSACOLA FL 32503 SANTA ROSA 26654001 MCGAW RX, INC THE MEDICINE SHOPPE 5524 STEWART ST MILTON FL 32570 SANTA ROSA 26836401 PARK AVENUE PHARMACY INC 5440 DOGWOOD DR MILTON FL 32570 SANTA ROSA 32617801 PUBLIX SUPER MARKETS, INC PUBLIX PHARMACY 1189 852 GULF BREEZE PKWY GULF BREEZE FL 32561 SANTA ROSA 731801 PH23686 PUBLIX SUPER MARKETS, INC PUBLIX PHARMACY #1313 2381 W STATE ROAD 434 LONGWOOD FL 32779 SANTA ROSA 26377001 PUBLIX SUPER MARKETS, INC PUBLIX PHARMACY 0896 8244 NAVARRE PKWY NAVARRE FL 32566 SANTA ROSA 361201 PUBLIX SUPER MARKETS, INC PUBLIX PHARMACY #1225 4739 HIGHWAY 90 PACE FL 32571 SANTA ROSA 4633601 RX EXPRESS PHARMACY OF MILTON, INC. RX EXPRESS PHARMACY 5941 BERRYHILL RD STE H MILTON FL 32570 SANTA ROSA 25532701 RX EXPRESS PHARMACY OF NAVARRE INC RX EXPRESS PHARMACY 1931 ORTEGA ST NAVARRE FL 32566 SANTA ROSA 30875700 1312188 SPECIALISTS OF ENTERPRISE, INC. 4964 HIGHWAY 90 STE B PACE FL 32571 SANTA ROSA 32160501 TARGET CORPORATION TARGET STORE T-2279 4727 HIGHWAY 90 PACE FL 32571 SANTA ROSA 25757501 WALGREEN #06210 WALGREEN CO 1459 TIGER PARK LN GULF BREEZE FL 32563 SANTA ROSA 1534401 WALGREEN CO WALGREENS 12300 6506 CAROLINE ST MILTON FL 32570 SANTA ROSA 31090501 WALGREEN CO WALGREEN 09535 8220 NAVARRE PKWY NAVARRE FL 32566 SANTA ROSA 22547901 WALGREEN CO. WALGREEN 05757 3909 HIGHWAY 90 PACE FL 32571 SANTA ROSA 109514501 PH0009483 WAL-MART #10-0990 PHARMACY MANAGER 4965 HIGHWAY 90 MILTON FL 32571 SANTA ROSA 106332401 WAL-MART PHARMACY #10-2533 WAL-MART STORES EAST,INC. 3767 GULF BREEZE PKWY GULF BREEZE FL 32563 SANTA ROSA 4776401 WAL-MART STORES EAST, LP WAL-MART PHARMACY 10-5623 334 GULF BREEZE PKWY GULF BREEZE FL 32561 SANTA ROSA 31888401 WAL-MART STORES EAST, LP WAL-MART PHARMACY 10-3439 9360 NAVARRE PKWY NAVARRE FL 32566 SANTA ROSA 100446802 WINKLES' PHARMACY 3818 HWY 90 EAST PACE FL 32571 SANTA ROSA
114 GULF MEDICAL SERVICES INC 6776 CAROLINE ST MILTON FL 32570 SANTA ROSA
1313672 HOVEROUND CORPORATION 5680 GULF BREEZE PKWY D6 GULF BREEZE FL 32563 SANTA ROSA
Provider Medicaid ID
License
Number Provider Name Doing Business As Name Street_1 Street_2 City State
Zip
Code County
672311096 MASH INC 379 E NELSON AVE DEFUNIAK SPRINGS FL 32433 WALTON
104725601 FISHER PHCY 688 BALDWIN AVENUE DEFUNIAK SPRGS FL 32433 WALTON 4329200 4234 HEALTHMARK OF WALTON, INC. HEALTHMARK HOME HEALTH
AGENCY 4413 US HIGHWAY 331 S DEFUNIAK SPRINGS FL 32435 WALTON
105773101 HOLIDAY CVS, LLC CVS PHARMACY 03684 35 POINCIANA BLVD DESTIN FL 32550 WALTON 201611700 95 M.A.S.H. INC. 379 EAST NELSON AVENUE DEFUNIAK SPRINGS FL 32433 WALTON 31129401 PRESCRIPTION PLACE DEFUNIAK SPRINGS THE PRESCRIPTION PLACE 1337 US HIGHWAY 90 W DEFUNIAK SPRINGS FL 32433 WALTON 26508001 PUBLIX SUPER MARKETS, INC PUBLIX PHARMACY 0885 725 GRAND BLVD SANDESTIN FL 32550 WALTON 1771801 PUBLIX SUPER MARKETS, INC. PUBLIX PHARMACY #1258 2038 US HIGHWAY 98 W SANTA ROSA BEACH FL 32459 WALTON 3789301 PH25428 SOUTH WALTON PHARMACY, LLC SANTA ROSA PHARMACY 19 TOWN CENTER LOOP UNIT 1A SANTA ROSA BEACH FL 32459 WALTON 31927901 WALGREEN CO WALGREENS 09914 1103 US HIGHWAY 331 S DEFUNIAK SPRINGS FL 32435 WALTON 109866701 WAL-MART #10-1134 1226 FREEPORT ROAD DEFUNIAK SPRINGS FL 32433 WALTON 3651801 WAL-MART STORES EAST, LP WAL-MART PHARMACY 10-5872 6712 US HIGHWAY 98 W SANTA ROSA BEACH FL 32459 WALTON 104210601 WEEKS PHARMACY 132 EAST HWY. 20 FREEPORT FL 32439 WALTON 103115501 WINN-DIXIE #577 WINN-DIXIE MTG INC. 103G US HIGHWAY 331 S DEFUNIAK SPRINGS FL 32435 WALTON
Respondent’s Name: