Healthcare Provider Details

I. General information

NPI: 1649584434
Provider Name (Legal Business Name): CITY CARE SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2010
Last Update Date: 06/29/2023
Certification Date: 06/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4008 E MILLER AVE
TAMPA FL
33617-7418
US

IV. Provider business mailing address

10621 BOYETTE CREEK BLVD
RIVERVIEW FL
33569-2721
US

V. Phone/Fax

Practice location:
  • Phone: 813-402-0444
  • Fax:
Mailing address:
  • Phone: 813-402-0444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPH24758
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. ANTHONY NWADI ONYEDIMMA
Title or Position: PHARMACIST
Credential:
Phone: 813-402-0444