Provider Demographics
NPI:1750770236
Name:PHARMACY CARE CENTER
Entity type:Organization
Organization Name:PHARMACY CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FADY
Authorized Official - Middle Name:
Authorized Official - Last Name:GIRGIS
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACIST
Authorized Official - Phone:888-971-4339
Mailing Address - Street 1:7413 MIAMI LAKES DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014
Mailing Address - Country:US
Mailing Address - Phone:888-971-4339
Mailing Address - Fax:305-821-4338
Practice Address - Street 1:7413 MIAMI LAKES DR
Practice Address - Street 2:SUITE B
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-6818
Practice Address - Country:US
Practice Address - Phone:888-971-4339
Practice Address - Fax:305-821-4338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-21
Last Update Date:2015-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH271993336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPH27199OtherSPECIAL STERILE COMPOUNDING