Healthcare Provider Details

I. General information

NPI: 1043049166
Provider Name (Legal Business Name): CAMRIN KERSH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2024
Last Update Date: 07/29/2024
Certification Date: 07/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2685 N FOREST RIDGE BLVD
HERNANDO FL
34442-5123
US

IV. Provider business mailing address

4093 S TOM AVE
INVERNESS FL
34452-7534
US

V. Phone/Fax

Practice location:
  • Phone: 352-527-6554
  • Fax:
Mailing address:
  • Phone: 352-464-5938
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS67362
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: