Provider Demographics
NPI:1932744521
Name:HEALTHCITE LLC
Entity Type:Organization
Organization Name:HEALTHCITE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHYAM SUNDAR
Authorized Official - Middle Name:REDDY
Authorized Official - Last Name:BUSIREDDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-742-2886
Mailing Address - Street 1:4500 W MIDWAY RD STE 105
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34981-4823
Mailing Address - Country:US
Mailing Address - Phone:772-742-2886
Mailing Address - Fax:772-212-2747
Practice Address - Street 1:4500 W MIDWAY RD STE 105
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34981-4823
Practice Address - Country:US
Practice Address - Phone:772-742-2886
Practice Address - Fax:772-212-2747
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTHCITE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-11-07
Last Update Date:2019-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy