Organization
BREVARD HEALTH ALLIANCE INC
Active
Other names
BHA Port St. John Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA CRAIG (DIRECTOR OF BILLING)
(321) 241-6834
Entity
Organization
Contact information
Practice address
7227 N HIGHWAY 1 STE 125, COCOA, FL 32927-5020
(321) 566-2703
(321) 566-2706
Mailing address
PO BOX 1137, MELBOURNE, FL 32902-1137
(321) 952-9696
(321) 952-7937
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
—
—
3336S0011X
Specialty Pharmacy
Primary
—
—
Other
Enumeration date
09/07/2022
Last updated
09/05/2023
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