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General NPI Number Information
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NPI Number | 1497713812
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Entity Type | Organization
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Legal Business Name | BELLEVIEW COMMUNITY PHARMACY, LLC
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Dates
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Enumeration Date | 05/03/2006
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Last Update Date | 10/23/2012
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Provider Practice Location Address
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Address Line | 2500 CITRUS BLVD.
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City | LEESBURG
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State | FL
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Zip | 34748-3063
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Country | US
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Telephone | 352-728-0477
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Fax | 352-315-3836
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Provider Business Mailing Address
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Address Line | 10762 SE US HWY 441
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City | BELLEVIEW
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State | FL
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Zip | 34420-3805
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Country | US
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Telephone | 352-347-4064
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Fax | 352-347-6832
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Authorized Official
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Title or Position | MANAGER/OWNER
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Name | MICHAEL CRIMI JR.
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Credential | P.A.
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Telephone | 352-427-8680
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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 | PH21895
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License Number State | FL
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