Provider Demographics
NPI:1205334109
Name:PA HEALTHCARE PHARMACEUTICAL COMPANY
Entity type:Organization
Organization Name:PA HEALTHCARE PHARMACEUTICAL COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-335-0180
Mailing Address - Street 1:7183 NAVAJO RD STE A
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92119-1650
Mailing Address - Country:US
Mailing Address - Phone:888-335-0180
Mailing Address - Fax:888-502-2754
Practice Address - Street 1:39029 COUNTY ROAD 54
Practice Address - Street 2:
Practice Address - City:ZEPHYRHILLS
Practice Address - State:FL
Practice Address - Zip Code:33542-6410
Practice Address - Country:US
Practice Address - Phone:888-335-0180
Practice Address - Fax:888-502-2754
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PA HEALTHCARE PHARMACEUTICAL COMPANY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-01-25
Last Update Date:2018-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies