Healthcare Provider Details

I. General information

NPI: 1235574013
Provider Name (Legal Business Name): SBCARE HEALTH NETWORK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2013
Last Update Date: 05/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2509 NE 14TH ST
OCALA FL
34470-4801
US

IV. Provider business mailing address

10007 SW 42ND AVE
OCALA FL
34476-4786
US

V. Phone/Fax

Practice location:
  • Phone: 352-484-1335
  • Fax:
Mailing address:
  • Phone: 352-484-1335
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPH26816
License Number StateFL

VIII. Authorized Official

Name: BOSEDE OLORUNLOGBON
Title or Position: DIRECTOR
Credential:
Phone: 352-299-5377