Provider Demographics
NPI:1093213662
Name:CAN COMMUNITY HEALTH INC.
Entity Type:Organization
Organization Name:CAN COMMUNITY HEALTH INC.
Other - Org Name:CAN COMMUNITY HEALTH PHARMACY OF FT LAUDERDALE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF PHARMACY OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:HANSIL
Authorized Official - Middle Name:
Authorized Official - Last Name:KALARIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-871-5161
Mailing Address - Street 1:2105 N NEBRASKA AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33602-2558
Mailing Address - Country:US
Mailing Address - Phone:813-871-5161
Mailing Address - Fax:
Practice Address - Street 1:4101 NW 3RD CT
Practice Address - Street 2:UNIT 9
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-2857
Practice Address - Country:US
Practice Address - Phone:844-370-6204
Practice Address - Fax:954-607-3534
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-29
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
FLPH314183336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL102225800Medicaid
2175661OtherPK