IndividualActive
Simon Van Wagenen, RPH
NPI 1790816072 · Pharmacist · Starke, FL
Simon Van Wagenen, RPH is a Pharmacist provider in Starke, FL (NPI 1790816072).
Provider details
- NPI number
- 1790816072
- Entity type
- Individual
- Primary specialty
- PharmacistPharmacy Service Providers
- Credential
- RPH
- Sex
- Male
- Sole proprietor
- No
- License
- PS16532 (FL)
Specialties & taxonomies
Pharmacy Service Providers
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
470 W Madison St
Starke, FL 32091-3926
Phone: (904) 964-6759
Fax: (904) 964-5315
Street-level locationGet directions
Mailing address
15604 Sw 161st St
Brooker, FL 32622-2540
Registry dates
- Enumerated
- 2007-03-08
- Last updated
- 2007-07-09
Frequently asked questions
- What is Simon Van Wagenen's NPI number?
- Simon Van Wagenen's National Provider Identifier (NPI) is 1790816072, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Simon Van Wagenen's specialty?
- Simon Van Wagenen is listed in the NPPES registry with a primary specialty of Pharmacist (Pharmacy Service Providers).
- Where is Simon Van Wagenen located?
- Simon Van Wagenen's practice location on file with NPPES is 470 W Madison St, Starke, FL 32091-3926.
- What is Simon Van Wagenen's phone number?
- The practice phone number listed in the NPPES registry for Simon Van Wagenen is (904) 964-6759.
- Is Simon Van Wagenen's NPI active?
- Yes — Simon Van Wagenen's NPI (1790816072) is active in the NPPES registry as of the last update on 2007-07-09.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.