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Organization

MEDICOR HEALTHCARE, INC

Active
Other names
Medicor Healthcare
Organization subpart
No

Provider details

NPI number
Authorized official
DWIGHT COLSTON (PHARMACY MANAGER)
(813) 930-8000
Entity
Organization

Contact information

Practice address
3403 W WATERS AVE, TAMPA, FL 33614-2713
(813) 930-8000
(813) 930-8026
Mailing address
3403 W WATERS AVE, TAMPA, FL 33614-2713
(813) 930-8000
(813) 930-8026

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
PH26927
FL
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
3336H0001X
Home Infusion Therapy Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2144161
PK
Enumeration date
07/21/2014
Last updated
07/21/2014
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