Provider Demographics
NPI:1114526100
Name:NEWGEN CLINICAL CARE PHARMACY LLC
Entity Type:Organization
Organization Name:NEWGEN CLINICAL CARE PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:CLEAVER
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:727-203-3202
Mailing Address - Street 1:6709 RIDGE RD STE 306
Mailing Address - Street 2:
Mailing Address - City:PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34668-6834
Mailing Address - Country:US
Mailing Address - Phone:727-203-3202
Mailing Address - Fax:727-203-3218
Practice Address - Street 1:6709 RIDGE RD STE 306
Practice Address - Street 2:
Practice Address - City:PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34668-6834
Practice Address - Country:US
Practice Address - Phone:727-203-3202
Practice Address - Fax:855-898-8002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-20
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistGroup - Single Specialty
No3336C0002XSuppliersPharmacyClinic Pharmacy