Healthcare Provider Details

I. General information

NPI: 1841577640
Provider Name (Legal Business Name): EVERCARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2011
Last Update Date: 05/15/2025
Certification Date: 05/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1611 N FLORIDA AVE
LAKELAND FL
33805-3107
US

IV. Provider business mailing address

PO BOX 90014
LAKELAND FL
33804-0014
US

V. Phone/Fax

Practice location:
  • Phone: 863-940-4733
  • Fax: 863-940-4734
Mailing address:
  • Phone: 863-940-4733
  • Fax: 863-940-4734

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPH25644
License Number StateFL

VIII. Authorized Official

Name: ISRAEL ENECHUKWU
Title or Position: PRESIDENT
Credential:
Phone: 863-940-4733