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General NPI Number Information
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NPI Number | 1922019421
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Entity Type | Organization
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Legal Business Name | PREVALENCE HEALTH LLC
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Dates
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Enumeration Date | 08/10/2006
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Last Update Date | 05/20/2008
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Provider Practice Location Address
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Address Line | 2501 DAVIE ROAD SUITE 210
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City | DAVIE
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State | FL
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Zip | 33317-7424
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Country | US
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Telephone | 954-635-6420
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Fax | 866-362-3293
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Provider Business Mailing Address
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Address Line | PO BOX 12648
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City | JACKSON
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State | MS
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Zip | 39236-2648
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Country | US
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Telephone | 601-981-0070
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Fax | 601-981-4513
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Authorized Official
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Title or Position | PRESIDENT
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Name | MICHAEL L ANTHONY
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Credential |
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Telephone | 601-981-0070
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | PH21965
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 3336M0002X
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Taxonomy Name | Mail Order Pharmacy
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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