Provider Demographics
NPI:1306005186
Name:ACCARDI CLINICAL SERVICES INC
Entity Type:Organization
Organization Name:ACCARDI CLINICAL SERVICES INC
Other - Org Name:ACCARDI CLINICAL PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:J ROGER
Authorized Official - Middle Name:
Authorized Official - Last Name:ACCARDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-774-5800
Mailing Address - Street 1:2583 S VOLUSIA AVE
Mailing Address - Street 2:STE 100
Mailing Address - City:ORANGE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32763-9129
Mailing Address - Country:US
Mailing Address - Phone:386-774-5800
Mailing Address - Fax:386-774-5656
Practice Address - Street 1:2583 S VOLUSIA AVE
Practice Address - Street 2:STE 100
Practice Address - City:ORANGE CITY
Practice Address - State:FL
Practice Address - Zip Code:32763-9129
Practice Address - Country:US
Practice Address - Phone:386-774-5800
Practice Address - Fax:386-774-5656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-05
Last Update Date:2010-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH164253336I0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336I0012XSuppliersPharmacyInstitutional Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1035307OtherNCPDP PROVIDER IDENTIFICATION NUMBER