Organization
SMA HEALTHCARE INC
Active
Parent organization
SMA HEALTHCARE INC
Other names
Act Corp.
Organization subpart
Yes
Provider details
NPI number
Legal business name
SMA HEALTHCARE INC
Authorized official
NICOLE SPROUL R.PH,, C.PH. (PAHRMACIST IN CHARGE)
(386) 236-1658
Entity
Organization
Contact information
Practice address
1220 WILLIS AVE, BLDG. 2, DAYTONA BEACH, FL 32114-2810
(386) 236-3188
(386) 239-6123
Mailing address
1220 WILLIS AVE, BLDG. 2, DAYTONA BEACH, FL 32114-2810
(386) 236-3188
(386) 239-6123
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
0010338
FL
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101630000
—
FL
Enumeration date
11/14/2005
Last updated
10/09/2023
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