Provider Demographics
NPI:1194193201
Name:VITACARE PRESCRIPTION SERVICES
Entity Type:Organization
Organization Name:VITACARE PRESCRIPTION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:FLYNN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-295-9880
Mailing Address - Street 1:951 YAMATO RD STE 160
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-4432
Mailing Address - Country:US
Mailing Address - Phone:561-961-1902
Mailing Address - Fax:800-891-4320
Practice Address - Street 1:951 YAMATO RD STE 160
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-4432
Practice Address - Country:US
Practice Address - Phone:561-961-1902
Practice Address - Fax:800-891-4320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-04
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336M0002XSuppliersPharmacyMail Order Pharmacy