Acquaviva'S Ltc Pharmacy

LBN: Carl D Acquaviva
Acquaviva'S Ltc Pharmacy is an health care organization with primary practice located at 1555 Port Malabar Blvd Ne Ste 102B , Palm Bay FL 32905-5407. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Long Term Care Pharmacy. Suppliers / Long Term Care Pharmacy is the primary health care specialty. Carl D Acquaviva can be contacted via phone (321) 725-7188, or through Acquaviva, Carl via phone (321) 768-1400.

Contact Information

Primary practice address
1555 Port Malabar Blvd Ne Ste 102B Palm Bay FL 32905-5407
Phone: (321) 725-7188
Fax: (321) 728-1333
Website:
Map and Directions
Authorized official contact:
Name: Acquaviva, Carl
Phone: (321) 768-1400

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X PH25270 Florida
Suppliers / Long Term Care Pharmacy 3336L0003X

Profile Details

NPI number 1780970673
LBN Legal business name Carl D Acquaviva
DBA Doing business as Acquaviva'S Ltc Pharmacy
Authorized official Acquaviva, Carl
Entity Organization
Organization subpart 1 No
Enumeration date Jun 20th, 2011
Last updated Feb 5th, 2019 - about 7 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780970673 NPPES
Florida MEDICAID 104293900
Florida Other 2131033

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