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Organization

OUTREACH COMMUNITY CARE NETWORK INC

Active
Parent organization
OUTREACH COMMUNITY CARE NETWORK
Organization subpart
Yes

Provider details

NPI number
Legal business name
OUTREACH COMMUNITY CARE NETWORK
Authorized official
DR. CHESTER WILSON JR. (EXECUTIVE DIRECTOR)
(386) 675-0098
Entity
Organization

Contact information

Practice address
240 N. FREDERICK AVENUE, DAYTONA BEACH, FL 32114
(386) 675-0118
(386) 257-1245
Mailing address
240 N. FREDERICK AVENUE, DAYTONA BEACH, FL 32114
(386) 675-0118
(386) 257-1245

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary

Other

Enumeration date
02/14/2019
Last updated
02/14/2019
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