Provider Demographics
NPI:1013226539
Name:SYMCARE INC
Entity Type:Organization
Organization Name:SYMCARE INC
Other - Org Name:RADIANTCARE PHARMACY AND COMPOUNDING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DIMEJI
Authorized Official - Middle Name:
Authorized Official - Last Name:LAWAL
Authorized Official - Suffix:
Authorized Official - Credentials:BSC PHARMACY
Authorized Official - Phone:964-629-5921
Mailing Address - Street 1:5779 S UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33328-6114
Mailing Address - Country:US
Mailing Address - Phone:954-530-4808
Mailing Address - Fax:
Practice Address - Street 1:5779 S UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33328-6114
Practice Address - Country:US
Practice Address - Phone:954-530-4808
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-01
Last Update Date:2010-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH24892333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPH24892OtherPHARMACY PERMIT