Provider Demographics
NPI:1194447094
Name:COMMUNITY CARE PHARMACY LLC
Entity type:Organization
Organization Name:COMMUNITY CARE PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NAJUM
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOUDHRY
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:561-213-1677
Mailing Address - Street 1:2828 S SEACREST BLVD STE 208
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33435-7944
Mailing Address - Country:US
Mailing Address - Phone:561-277-0398
Mailing Address - Fax:561-277-0864
Practice Address - Street 1:2828 S SEACREST BLVD STE 208
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33435-7944
Practice Address - Country:US
Practice Address - Phone:561-277-0398
Practice Address - Fax:561-277-0864
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-16
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy