MEDICARE: CAN COMMUNITY HEALTH 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
2	3336C0003X	Community/Retail Pharmacy	PH31164	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2170567	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1912448895
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAN COMMUNITY HEALTH INC.

Provider Business Mailing Address
First Line	:	2105 N NEBRASKA AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33602-2558
Country	:	US
Telephone Number	:	813-871-5161
Fax Number	:

Provider Business Practice Location Address
First Line	:	2349 SUNSET POINT RD
Second Line	:	SUITE 404
City	:	CLEARWATER
State	:	FL
Zip	:	33765-1456
Country	:	US
Telephone Number	:	844-370-6204
Fax Number	:	727-456-8072

Authorized Official
Title or Position	:	CHIEF PHARMACY OFFICER
Name	:	HANSIL KALARIA
Credential	:
Telephone Number	:	813-871-5161

Provider Enumeration Date	:	03/13/2017
Last Update Date	:	01/30/2024

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