Healthcare Provider Details

I. General information

NPI: 1740320399
Provider Name (Legal Business Name): GOLDENCARE PHARMACEUTICALS& IV,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 10/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11908 MIRAMAR PKWY
MIRAMAR FL
33025-7005
US

IV. Provider business mailing address

11908 MIRAMAR PKWY
MIRAMAR FL
33025-7005
US

V. Phone/Fax

Practice location:
  • Phone: 866-581-7099
  • Fax:
Mailing address:
  • Phone: 866-581-7099
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License NumberPH22056
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberPH22056
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPH22056
License Number StateFL

VIII. Authorized Official

Name: GREG GAISER
Title or Position: SVP OF SALES AND OPERATIONS
Credential: RPH,DPH
Phone: 866-581-7099