Provider Demographics
NPI:1598805285
Name:PRESCRIPTION CARE PHARMACY
Entity Type:Organization
Organization Name:PRESCRIPTION CARE PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:IRWIN
Authorized Official - Middle Name:
Authorized Official - Last Name:GOTTLIEB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-985-3999
Mailing Address - Street 1:5820 STIRLING RD
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-1527
Mailing Address - Country:US
Mailing Address - Phone:954-985-3999
Mailing Address - Fax:
Practice Address - Street 1:5820 STIRLING RD
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-1527
Practice Address - Country:US
Practice Address - Phone:954-985-3999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL022446401Medicaid