Organization
EVERCARE INC
Active
Other names
Supreme Rx Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ISRAEL ENECHUKWU (PRESIDENT)
(863) 940-4733
Entity
Organization
Contact information
Practice address
1611 N FLORIDA AVE, LAKELAND, FL 33805-3107
(863) 940-4733
(863) 940-4734
Mailing address
PO BOX 90014, LAKELAND, FL 33804-0014
(863) 940-4733
(863) 940-4734
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH25644
FL
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004275800
—
FL
01
—
2132624
PK
—
Enumeration date
11/08/2011
Last updated
05/15/2025
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