Organization
SHANDS TEACHING HOSPITAL AND CLINICS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL D. HOLMES (CEO)
(352) 733-1500
Entity
Organization
Contact information
Practice address
4197 NW 86TH TERRACE, SUITE 1131, GAINESVILLE, FL 32606-6271
(352) 733-0090
(352) 733-0098
Mailing address
PO BOX 100303, GAINESVILLE, FL 32610-0303
(352) 627-9045
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PH13786
FL
3336C0003X
Community/Retail Pharmacy
PH13786
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1040308
NCPDP NUMBER
FL
05
—
106077500
—
FL
01
—
1396804373
NPI NUMBER
FL
01
—
DSH100113C
340B NUMBER
FL
01
—
P3733
BCBS PROVIDER NUMBER
FL
Enumeration date
12/06/2006
Last updated
12/31/2025
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