1063258119 NPI number — RX CARE PHARMACY AND KWICKMART INC

Table of content: (NPI 1063258119)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063258119 NPI number — RX CARE PHARMACY AND KWICKMART INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RX CARE PHARMACY AND KWICKMART INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1063258119
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/02/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
14306 7TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DADE CITY
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33523-3434
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
813-500-9324
Provider Business Mailing Address Fax Number:
352-567-2259

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
14306 7TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DADE CITY
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33523-3434
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
352-567-2238
Provider Business Practice Location Address Fax Number:
352-567-2229
Provider Enumeration Date:
07/08/2024

Additional Information

Authorized Official

Authorized Official Last Name:
PATEL
Authorized Official First Name:
HARESH
Authorized Official Middle Name:
C
Authorized Official Title or Position:
PHARMACY MANAGER
Authorized Official Telephone Number:
352-567-2238

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com