Provider Demographics
NPI:1982039731
Name:BAYCARE HOME CARE INC
Entity Type:Organization
Organization Name:BAYCARE HOME CARE INC
Other - Org Name:BAYCARE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:IQBAL
Authorized Official - Middle Name:
Authorized Official - Last Name:BURNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-394-6577
Mailing Address - Street 1:8452 118TH AVE
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33773-5007
Mailing Address - Country:US
Mailing Address - Phone:813-357-0630
Mailing Address - Fax:813-357-0631
Practice Address - Street 1:3003 W DR MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6307
Practice Address - Country:US
Practice Address - Phone:813-357-0630
Practice Address - Fax:813-357-0631
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-12
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH270603336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2142050OtherPK