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Contact Information

EBENEZER CLINICAL PHARMACY LLC
518 CYPRESS PARKWAY RD
KISSIMMEE, FL34759
 Phone: 407-785-1713
 Fax: 407-785-1713
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Clinic Pharmacy

3336C0002X 58 Medical Supply Company with Pharmacist
 

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for EBENEZER CLINICAL PHARMACY LLC

NPI # 1285161083
LBN Legal business name EBENEZER CLINICAL PHARMACY LLC
Authorized official TINA IHERA - (PHARMACIST/OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 05/11/2017
Last updated 04/10/2023 - About 3 years ago
Identifiers
FL License # PH30718
Other 2171741 PK
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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