Healthcare Provider Details

I. General information

NPI: 1598270324
Provider Name (Legal Business Name): HEALTH CARE DISTRICT OF PALM BEACH COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2017
Last Update Date: 12/20/2024
Certification Date: 12/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 W INDIANTOWN RD
JUPITER FL
33458-3538
US

IV. Provider business mailing address

1515 N FLAGLER DR STE 101
WEST PALM BEACH FL
33401-3429
US

V. Phone/Fax

Practice location:
  • Phone: 561-209-2572
  • Fax:
Mailing address:
  • Phone: 561-659-1270
  • Fax: 561-733-6663

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPH30963
License Number StateFL

VIII. Authorized Official

Name: DARCY DAVIS
Title or Position: CEO
Credential:
Phone: 561-804-5885