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General NPI Number Information
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NPI Number | 1205820107
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Entity Type | Organization
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Legal Business Name | MED-CARE MEDS
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Dates
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Enumeration Date | 09/07/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3300 SW 15TH ST SUITE 105
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City | DEERFIELD BEACH
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State | FL
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Zip | 33442-8126
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Country | US
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Telephone | 800-899-4852
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Fax | 800-823-7505
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Provider Business Mailing Address
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Address Line | 3300 SW 15TH ST SUITE 105
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City | DEERFIELD BEACH
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State | FL
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Zip | 33442-8126
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Country | US
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Telephone | 800-899-4852
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Fax | 800-823-7505
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. SCOTT BENNETT PORTMAN
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Credential | R.PH..
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Telephone | 800-899-4852
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PH21500
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License Number State | FL
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