Organization
TAKA HEALTH LLC
Active
Other names
PROCARE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
THANH-THUY NGUYEN RPH (PHARMACY MANAGER)
(407) 730-2770
Entity
Organization
Contact information
Practice address
1084 LEE RD STE 4, ORLANDO, FL 32810-5821
(407) 730-2770
(407) 730-2764
Mailing address
1084 LEE RD, SUITE 4, ORLANDO, FL 32810-5821
(407) 730-2770
(407) 730-2764
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH25991
FL
3336C0004X
Compounding Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004619700
—
FL
01
—
2134152
PK
—
Enumeration date
03/08/2012
Last updated
03/06/2017
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