Provider Demographics
NPI:1588016315
Name:ADOM HEALTHCARE LLC
Entity Type:Organization
Organization Name:ADOM HEALTHCARE LLC
Other - Org Name:CAREPOINT RX PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NADEGE
Authorized Official - Middle Name:
Authorized Official - Last Name:CASSEUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-515-6311
Mailing Address - Street 1:7347 SPRING HILL DR
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34606-4300
Mailing Address - Country:US
Mailing Address - Phone:352-515-6311
Mailing Address - Fax:352-515-6371
Practice Address - Street 1:7347 SPRING HILL DR
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34606-4300
Practice Address - Country:US
Practice Address - Phone:352-515-6311
Practice Address - Fax:352-515-6371
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-05
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
FLPH302343336C0003X, 333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL019177800Medicaid
2162275OtherPK