Provider Demographics
NPI:1376616698
Name:SIMED HEALTH LLC
Entity Type:Organization
Organization Name:SIMED HEALTH LLC
Other - Org Name:SIMEDHEALTH PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:MARTIN
Authorized Official - Last Name:DUNCANSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-224-2200
Mailing Address - Street 1:4343 W NEWBERRY RD
Mailing Address - Street 2:SUITE 9
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32607-2817
Mailing Address - Country:US
Mailing Address - Phone:352-224-2450
Mailing Address - Fax:352-224-2451
Practice Address - Street 1:4343 W NEWBERRY RD
Practice Address - Street 2:SUITE 9
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-2817
Practice Address - Country:US
Practice Address - Phone:352-224-2450
Practice Address - Fax:352-224-2451
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SIMED HEALTH LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-16
Last Update Date:2018-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH213123336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL030860900Medicaid