Organization
SUNCOAST VITAL CARE INC
Active
Other names
SUNCOAST VITAL CARE
Organization subpart
No
Provider details
NPI number
Authorized official
CHIRAG AMIN (PHARMACIST)
(352) 686-1866
Entity
Organization
Contact information
Practice address
5330 SPRING HILL DR, STE E, SPRING HILL, FL 34606-4543
(352) 686-1866
(352) 686-1840
Mailing address
5330 SPRING HILL DR, STE E, SPRING HILL, FL 34606-4543
(352) 686-1866
(325) 686-1840
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
PH11906
FL
3336C0003X
Community/Retail Pharmacy
Primary
PH11906
FL
3336C0004X
Compounding Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000483800
MEDICAID PHARMACY
FL
01
—
000483801
MEDICAID DME
FL
01
—
1078559
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
07/14/2006
Last updated
06/18/2010
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