Healthcare Provider Details

I. General information

NPI: 1164762381
Provider Name (Legal Business Name): RITECARE HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/25/2013
Last Update Date: 05/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12014 E COLONIAL DR STE 140
ORLANDO FL
32826-4751
US

IV. Provider business mailing address

12014 E COLONIAL DR STE 140
ORLANDO FL
32826-4750
US

V. Phone/Fax

Practice location:
  • Phone: 407-203-6895
  • Fax: 407-203-6897
Mailing address:
  • Phone: 407-203-6895
  • Fax: 407-203-6897

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPH26581
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ANH-PHUONG VU
Title or Position: MANAGER
Credential:
Phone: 407-203-6895