Organization
FLORIDA DEPARTMENT OF HEALTH
Active
Other names
Childrens Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES HENRY (ADMINISTRATOR)
(941) 861-2950
Entity
Organization
Contact information
Practice address
1750 17TH ST, BLDG E, SARASOTA, FL 34234-8632
(941) 861-1424
Mailing address
1750 17TH ST, BLDG E, SARASOTA, FL 34234-8632
(941) 861-1424
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
Primary
PH 28273
FL
3336M0003X
Managed Care Organization Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2146807
PK
—
Enumeration date
07/21/2014
Last updated
10/22/2024
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