MEDICARE: CIRCLES OF CARE INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy	PH13653	FL

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	:	1124177951
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CIRCLES OF CARE INC

Provider Business Mailing Address
First Line	:	2020 COMMERCE DRIVE
Second Line	:
City	:	WEST MELBOURNE
State	:	FL
Zip	:	32904-2335
Country	:	US
Telephone Number	:	321-952-6020
Fax Number	:	321-952-6037

Provider Business Practice Location Address
First Line	:	2020 COMMERCE DRIVE
Second Line	:
City	:	WEST MELBOURNE
State	:	FL
Zip	:	32904-2335
Country	:	US
Telephone Number	:	321-952-6020
Fax Number	:	321-952-6037

Authorized Official
Title or Position	:	DIRECTOR OF PHARMACIES
Name	:	LISA B BAUMAN
Credential	:	BPHARM
Telephone Number	:	321-914-4815

Provider Enumeration Date	:	01/10/2007
Last Update Date	:	03/10/2021

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