Provider Demographics
NPI:1427160357
Name:PROCARE PHARMACY CARE, LLC
Entity type:Organization
Organization Name:PROCARE PHARMACY CARE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PHARMACY MANAGER / PIC
Authorized Official - Prefix:DR
Authorized Official - First Name:ANA
Authorized Official - Middle Name:VICTORIA
Authorized Official - Last Name:MOLINA
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:321-319-4096
Mailing Address - Street 1:2850 N COMMERCE PKWY
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-3958
Mailing Address - Country:US
Mailing Address - Phone:800-662-0586
Mailing Address - Fax:800-662-0590
Practice Address - Street 1:2850 N COMMERCE PKWY
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-3958
Practice Address - Country:US
Practice Address - Phone:800-662-0586
Practice Address - Fax:800-662-0590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336M0002X, 3336S0011X
FLPH190853336M0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336M0002XSuppliersPharmacyMail Order Pharmacy
No333600000XSuppliersPharmacy
No3336M0003XSuppliersPharmacyManaged Care Organization Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2015335OtherPK
FL6212150001Medicare NSC