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General NPI Number Information
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NPI Number | 1699113902
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Entity Type | Organization
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Legal Business Name | MED CARE CHOICE PHARMACY, INC.
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Dates
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Enumeration Date | 06/08/2013
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Last Update Date | 07/30/2013
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Provider Practice Location Address
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Address Line | 3570 CONSUMER ST 8
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City | RIVIERA BEACH
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State | FL
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Zip | 33404-1740
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Country | US
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Telephone | 561-283-1243
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Fax |
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Provider Business Mailing Address
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Address Line | 3570 CONSUMER ST 8
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City | RIVIERA BEACH
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State | FL
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Zip | 33404-1740
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Country | US
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Telephone | 561-283-1243
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TREPHENE BROWN
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Credential |
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Telephone | 561-283-1243
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336M0002X
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Taxonomy Name | Mail Order Pharmacy
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License Number | PH26972
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PH26972
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License Number State | FL
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