Provider Demographics
NPI:1104045012
Name:HEALTH CARE DISTRICT OF PALM BEACH COUNTY
Entity type:Organization
Organization Name:HEALTH CARE DISTRICT OF PALM BEACH COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DARCY
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-804-5600
Mailing Address - Street 1:1515 N FLAGLER DR STE 101
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-3429
Mailing Address - Country:US
Mailing Address - Phone:561-659-1270
Mailing Address - Fax:561-733-6663
Practice Address - Street 1:4801 S CONGRESS AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33461
Practice Address - Country:US
Practice Address - Phone:561-209-2575
Practice Address - Fax:844-206-6437
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
FLPH219393336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2005980OtherPK
FL114044400Medicaid