Organization
BSN HEALTH
Active
Other names
Family Care Clinic Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
NARSI HATAM POUR (VICE PRESIDENT)
(863) 866-9660
Entity
Organization
Contact information
Practice address
45665 HIGHWAY 27, DAVENPORT, FL 33897-4546
(863) 866-9660
(863) 353-1190
Mailing address
45665 HIGHWAY 27, DAVENPORT, FL 33897-4546
(863) 866-9660
(863) 353-1190
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PH32608
BOARD OF PHARMACY LICENSE
FL
Enumeration date
03/04/2020
Last updated
03/04/2020
Update your record
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