Provider Demographics
NPI:1750187258
Name:LARKIN COMMUNITY HOSPITAL PALM SPRINGS CAMPUS, LLC
Entity type:Organization
Organization Name:LARKIN COMMUNITY HOSPITAL PALM SPRINGS CAMPUS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PHARMACY
Authorized Official - Prefix:DR
Authorized Official - First Name:GIJO
Authorized Official - Middle Name:
Authorized Official - Last Name:MATHEW
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD, MBA, BCPS
Authorized Official - Phone:305-558-2500
Mailing Address - Street 1:1475 W 49TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-3222
Mailing Address - Country:US
Mailing Address - Phone:305-824-4771
Mailing Address - Fax:305-824-4758
Practice Address - Street 1:1475 W 49TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3222
Practice Address - Country:US
Practice Address - Phone:305-824-4771
Practice Address - Fax:305-824-4758
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-24
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy