Provider Demographics
NPI:1205820107
Name:MED-CARE MEDS
Entity type:Organization
Organization Name:MED-CARE MEDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:BENNETT
Authorized Official - Last Name:PORTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:800-899-4852
Mailing Address - Street 1:3300 SW 15TH ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33442-8126
Mailing Address - Country:US
Mailing Address - Phone:800-899-4852
Mailing Address - Fax:800-823-7505
Practice Address - Street 1:3300 SW 15TH ST
Practice Address - Street 2:SUITE 105
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33442-8126
Practice Address - Country:US
Practice Address - Phone:800-899-4852
Practice Address - Fax:800-823-7505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH21500183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPH21500OtherPHARMACY LICENSE