Organization
FLORIDA DEPARTMENT OF HEALTH
Active
Other names
SOUTH COUNTY HEALTH CENTER PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL D'AMICO (PHARMACEUTICAL PROGRAM MGR)
(941) 861-2932
Entity
Organization
Contact information
Practice address
7820 TAMIAMI TRL S, BUILD B 2, VENICE, FL 34293-5120
(941) 861-3352
(941) 861-3357
Mailing address
PO BOX 2658, SARASOTA, FL 34230-2658
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
PH17376
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
022273900
—
FL
01
—
1090276
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
06/11/2006
Last updated
11/23/2010
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