MEDICARE: PRICARE HEALTH LLC

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	261QP2300X	Primary Care Clinic/Center
2	261Q00000X	Clinic/Center

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	:	1457826398
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRICARE HEALTH LLC

Provider Business Mailing Address
First Line	:	PO BOX 17175
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33682-7175
Country	:	US
Telephone Number	:	813-220-1400
Fax Number	:

Provider Business Practice Location Address
First Line	:	6506 EMBASSY BLVD
Second Line	:
City	:	PORT RICHEY
State	:	FL
Zip	:	34668-4734
Country	:	US
Telephone Number	:	727-378-2987
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	STEPHEN O BANJOKO
Credential	:
Telephone Number	:	212-257-0225

Provider Enumeration Date	:	10/08/2018
Last Update Date	:	08/09/2024

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Directions to “PRICARE HEALTH LLC ” Practice Location

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