Healthcare Provider Details

I. General information

NPI: 1245275551
Provider Name (Legal Business Name): CONTINUUMCARE PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2006
Last Update Date: 02/13/2024
Certification Date: 02/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

78 PERRY WINKLE LN
HUNTINGTON WV
25702-9506
US

IV. Provider business mailing address

3802 CORPOREX PARK DR STE 200
TAMPA FL
33619-1125
US

V. Phone/Fax

Practice location:
  • Phone: 304-736-8310
  • Fax: 304-736-8312
Mailing address:
  • Phone: 813-318-6039
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License NumberMP0552385
License Number StateWV

VIII. Authorized Official

Name: ALLISON L. BROWN
Title or Position: SECRETARY
Credential:
Phone: 502-630-7429