Provider Demographics
NPI:1891086393
Name:PLANTATION GENERAL HOSPITAL L P
Entity Type:Organization
Organization Name:PLANTATION GENERAL HOSPITAL L P
Other - Org Name:MERCY PROF PHARM, HCA FLORIDA MERCY HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:HUNTER
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-285-2904
Mailing Address - Street 1:3663 S MIAMI AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-4253
Mailing Address - Country:US
Mailing Address - Phone:305-285-2762
Mailing Address - Fax:305-285-2606
Practice Address - Street 1:3663 S MIAMI AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-4253
Practice Address - Country:US
Practice Address - Phone:305-285-2762
Practice Address - Fax:305-285-2606
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PLANTATION GENERAL HOSPITAL L P
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-05-02
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
FLPH254573336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2130956OtherPK
5706479OtherNCPDP PROVIDER IDENTIFICATION NUMBER