MEDICARE: NEWGEN CLINICAL CARE PHARMACY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
2	3336C0002X	Clinic Pharmacy
3	3336C0003X	Community/Retail Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114526100
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEWGEN CLINICAL CARE PHARMACY LLC

Provider Business Mailing Address
First Line	:	6709 RIDGE RD STE 306
Second Line	:
City	:	PORT RICHEY
State	:	FL
Zip	:	34668-6867
Country	:	US
Telephone Number	:	727-203-3202
Fax Number	:	855-898-8002

Provider Business Practice Location Address
First Line	:	6709 RIDGE RD STE 306
Second Line	:
City	:	PORT RICHEY
State	:	FL
Zip	:	34668-6834
Country	:	US
Telephone Number	:	727-203-3202
Fax Number	:	855-898-8002

Authorized Official
Title or Position	:	PHARMACIST IN CHARGE/OWNER
Name	:	DR. VIRGINIA DENISE CLEAVER
Credential	:	PHARMD
Telephone Number	:	727-203-3202

Provider Enumeration Date	:	10/20/2020
Last Update Date	:	01/30/2026

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