Provider Demographics
NPI:1740320399
Name:GOLDENCARE PHARMACEUTICALS& IV,LLC
Entity type:Organization
Organization Name:GOLDENCARE PHARMACEUTICALS& IV,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SVP OF SALES AND OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:GREG
Authorized Official - Middle Name:
Authorized Official - Last Name:GAISER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH,DPH
Authorized Official - Phone:866-581-7099
Mailing Address - Street 1:11908 MIRAMAR PKWY
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-7005
Mailing Address - Country:US
Mailing Address - Phone:866-581-7099
Mailing Address - Fax:
Practice Address - Street 1:11908 MIRAMAR PKWY
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-7005
Practice Address - Country:US
Practice Address - Phone:866-581-7099
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2007-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH22056251F00000X, 332B00000X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251F00000XAgenciesHome Infusion
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5718380001Medicare NSC
FL5718380001Medicare ID - Type Unspecified