Healthcare Provider Details

I. General information

NPI: 1477299352
Provider Name (Legal Business Name): EPIC CARE PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2022
Last Update Date: 05/26/2022
Certification Date: 05/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3948 PEMBROKE RD STE D
PEMBROKE PARK FL
33021-8114
US

IV. Provider business mailing address

1002 NW 139TH TER
PEMBROKE PINES FL
33028-2340
US

V. Phone/Fax

Practice location:
  • Phone: 954-963-2113
  • Fax:
Mailing address:
  • Phone: 954-963-2113
  • Fax: 954-963-2113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ALVANETA OSBOURNE
Title or Position: OWNER
Credential:
Phone: 954-963-2113