Healthcare Provider Details

I. General information

NPI: 1326410952
Provider Name (Legal Business Name): SUNCOAST COMMUNITY HEALTH CENTERS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2015
Last Update Date: 12/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

313 S LAKEWOOD DR
BRANDON FL
33511-2815
US

IV. Provider business mailing address

PO BOX 1349
RUSKIN FL
33575-1349
US

V. Phone/Fax

Practice location:
  • Phone: 813-349-7949
  • Fax: 813-685-9188
Mailing address:
  • Phone: 813-349-7959
  • Fax: 813-349-7869

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPH29455
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: JEFF HUNT
Title or Position: PHARMACY DIRECTOR
Credential:
Phone: 813-349-7959