Healthcare Provider Details
I. General information
NPI: 1154379378
Provider Name (Legal Business Name): COMPREHENSIVE HOME CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/04/2006
Last Update Date: 08/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
12916 SW 132ND CT
MIAMI FL
33186-5819
US
IV. Provider business mailing address
12916 SW 132ND CT
MIAMI FL
33186-5819
US
V. Phone/Fax
- Phone: 305-235-1072
- Fax: 305-235-1087
- Phone: 305-235-1072
- Fax: 305-235-1087
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | PH0014208 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0004X |
| Taxonomy | Compounding Pharmacy |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336H0001X |
| Taxonomy | Home Infusion Therapy Pharmacy |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336S0011X |
| Taxonomy | Specialty Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JULIE
SMITH BAZAN
Title or Position: PHCY MNGR
Credential: PHARM D
Phone: 305-235-1072