Provider Demographics
NPI:1477978567
Name:GSP HEALTHCARE
Entity Type:Organization
Organization Name:GSP HEALTHCARE
Other - Org Name:RITEMED
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GOWRIBAI
Authorized Official - Middle Name:
Authorized Official - Last Name:ANBALAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-276-1146
Mailing Address - Street 1:13726 LAKE CAWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WINDERMERE
Mailing Address - State:FL
Mailing Address - Zip Code:34786-7005
Mailing Address - Country:US
Mailing Address - Phone:321-206-3516
Mailing Address - Fax:
Practice Address - Street 1:2130 MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-2927
Practice Address - Country:US
Practice Address - Phone:321-276-1146
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-26
Last Update Date:2014-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH275103336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy