Provider Demographics
NPI:1598864050
Name:FRESENIUS MEDICAL CARE PHARMACY SERVICES, INC.
Entity Type:Organization
Organization Name:FRESENIUS MEDICAL CARE PHARMACY SERVICES, INC.
Other - Org Name:FMC PHARMACY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:HARON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-764-6529
Mailing Address - Street 1:11001 DANKA WAY NORTH
Mailing Address - Street 2:SUITE 2
Mailing Address - City:ST. PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33716-3724
Mailing Address - Country:US
Mailing Address - Phone:800-947-3131
Mailing Address - Fax:727-568-0514
Practice Address - Street 1:11001 DANKA WAY NORTH
Practice Address - Street 2:SUITE 2
Practice Address - City:ST. PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33716-3724
Practice Address - Country:US
Practice Address - Phone:800-947-3131
Practice Address - Fax:727-568-0514
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRESENIUS MEDICAL CARE INTEGRATED CARE GROUP, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-21
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH170203336C0003X, 3336C0003X
FLPH274433336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL031804300Medicaid
1295960001Medicare NSC