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General NPI Number Information
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NPI Number | 1164050761
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Entity Type | Organization
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Legal Business Name | PCA FLORIDA RX, LLC
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Dates
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Enumeration Date | 03/30/2020
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Last Update Date | 03/06/2025
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Provider Practice Location Address
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Address Line | 4011 CRESCENT PARK DR
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City | RIVERVIEW
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State | FL
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Zip | 33578-3605
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Country | US
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Telephone | 813-499-9340
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Fax |
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Provider Business Mailing Address
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Address Line | 303 N HURSTBOURNE PKWY STE 200
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City | LOUISVILLE
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State | KY
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Zip | 40222-5158
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Country | US
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Telephone | 813-499-9340
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DAVID DAVIS
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Credential |
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Telephone | 502-412-5847
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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