Provider Demographics
NPI:1518405968
Name:PATIENT CARE AMERICA
Entity Type:Organization
Organization Name:PATIENT CARE AMERICA
Other - Org Name:DIABETIC CARE RX
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF OPERATIONS/ PIC
Authorized Official - Prefix:
Authorized Official - First Name:CAROLINE
Authorized Official - Middle Name:
Authorized Official - Last Name:ELLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-348-0441
Mailing Address - Street 1:3890 PARK CENTRAL BLVD N
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33064-2264
Mailing Address - Country:US
Mailing Address - Phone:866-348-0441
Mailing Address - Fax:
Practice Address - Street 1:3890 PARK CENTRAL BLVD N
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33064-2264
Practice Address - Country:US
Practice Address - Phone:866-348-0441
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PATIENT CARE AMERICA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-02-06
Last Update Date:2017-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH22190332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies