Crestview Pharmacy, LLC
Crestview Pharmacy, LLC is a healthcare organization registered as Community/Retail Pharmacy in Crestview, FL, holding Type 2 (organization) NPI 1407965262 since 2006. The authorized official on file is Vince Dagrava, Coo.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1407965262 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Crestview Pharmacy, LLC |
| Other name | <Unavail> |
| Practice address | 1116 N FERDON BLVD, Crestview, FL, 32536 |
| Phone | 8506831111 |
| Fax | 8506831753 |
| Enumeration date | 2006-08-29 |
| Last updated in NPPES | 2019-06-11 |
Authorized official
| Name | Vince Dagrava |
|---|---|
| Title | Coo |
| Phone | 8595525013 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 3336C0003X | Community/Retail Pharmacy | Primary | PH18397 | FL |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100200027 | Medicaid | AL | — |
| 025327800 | Medicaid | FL | — |
| 1094870 | Other | FL | NCPDP - NAPB |
Copy-ready billing details
Provider: Crestview Pharmacy, LLC NPI: 1407965262 Taxonomy: 3336C0003X (Community/Retail Pharmacy) Address: 1116 N FERDON BLVD, Crestview, FL, 32536
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1487663803 | Hal Densman | Individual | Pharmacist | Crestview, FL |
| 1346581030 | Melvin Livingston | Individual | Pharmacist | Crestview, FL |
| 1699321331 | Jennifer Wood | Individual | Pharmacist | Crestview, FL |
| 1255987996 | Emily Blackmon | Individual | Pharmacist | Crestview, FL |
Verify this record
Cross-check NPI 1407965262 against the authoritative CMS record: view Crestview Pharmacy, LLC on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
What is a Type 2 NPI?
What type of organization is Crestview Pharmacy, LLC?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2019-06-11.