Healthcare Provider Details

I. General information

NPI: 1306333497
Provider Name (Legal Business Name): CARELINE PHARMACY AND HEALTHCARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2018
Last Update Date: 05/21/2021
Certification Date: 05/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11200 E MARTIN LUTHER KING BLVD STE 103
SEFFNER FL
33584-3358
US

IV. Provider business mailing address

11200 E MARTIN LUTHER KING BLVD STE 103
SEFFNER FL
33584-8348
US

V. Phone/Fax

Practice location:
  • Phone: 813-333-0870
  • Fax: 813-235-4726
Mailing address:
  • Phone: 813-333-0870
  • Fax: 813-235-4725

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 NumberPH31332
License Number StateFL

VIII. Authorized Official

Name: SAKYI KOBINA SARSAH
Title or Position: DIRECTOR
Credential: DR
Phone: 813-333-0870