Provider Demographics
NPI:1528589926
Name:DOCTORS CARE BHRT AND VITAMIN CENTER LLC
Entity Type:Organization
Organization Name:DOCTORS CARE BHRT AND VITAMIN CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:BAZZONE
Authorized Official - Suffix:
Authorized Official - Credentials:OFFICE MANAGER
Authorized Official - Phone:727-424-5780
Mailing Address - Street 1:10051 LORRAINE RD STE B
Mailing Address - Street 2:
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39503-6001
Mailing Address - Country:US
Mailing Address - Phone:228-604-4546
Mailing Address - Fax:228-604-4540
Practice Address - Street 1:10051 LORRAINE RD STE B
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39503-6001
Practice Address - Country:US
Practice Address - Phone:228-604-4546
Practice Address - Fax:228-604-4540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center