Healthcare Provider Details

I. General information

NPI: 1255496683
Provider Name (Legal Business Name): CAREMED HEALTH CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/26/2006
Last Update Date: 02/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3480 MORNING LAKE DR UNIT 202
BONITA SPRINGS FL
34134-9160
US

IV. Provider business mailing address

3480 MORNING LAKE DR UNIT 202
BONITA SPRINGS FL
34134-9160
US

V. Phone/Fax

Practice location:
  • Phone: 239-949-9036
  • Fax:
Mailing address:
  • Phone: 239-949-9036
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPH17697
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ROSCOE HEIM
Title or Position: PRES
Credential: PHARMACIST
Phone: 239-992-7633