Provider Demographics
NPI:1285705079
Name:CITICARE MEDICAL SUPPLIES INC
Entity type:Organization
Organization Name:CITICARE MEDICAL SUPPLIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:JENNIFER
Authorized Official - Last Name:CREARY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-243-9777
Mailing Address - Street 1:303 N HIGHWAY 27
Mailing Address - Street 2:C1
Mailing Address - City:MINNEOLA
Mailing Address - State:FL
Mailing Address - Zip Code:34715-7707
Mailing Address - Country:US
Mailing Address - Phone:352-243-9777
Mailing Address - Fax:352-243-9717
Practice Address - Street 1:303 N HIGHWAY 27
Practice Address - Street 2:C1
Practice Address - City:MINNEOLA
Practice Address - State:FL
Practice Address - Zip Code:34715-7707
Practice Address - Country:US
Practice Address - Phone:352-243-9777
Practice Address - Fax:352-243-9717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLP06000129372332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies