Healthcare Provider Details

I. General information

NPI: 1275835019
Provider Name (Legal Business Name): CLINICAL CARE PHARMACY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2010
Last Update Date: 07/02/2021
Certification Date: 07/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4765 W. 8TH AVENUE SUITE 303
HIALEAH FL
33012-3554
US

IV. Provider business mailing address

1400 NW 107TH AVENUE SUITE 500
MIAMI FL
33172
US

V. Phone/Fax

Practice location:
  • Phone: 786-454-9852
  • Fax: 305-556-6644
Mailing address:
  • Phone: 786-454-9852
  • Fax: 305-556-6644

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: XAVIER ALARCON
Title or Position: CFO
Credential:
Phone: 305-534-0076