Organization · NPI-2
Panacea Health Systems LLC
Clinic/Center · Chiefland, FL
NPI number1639717374
StatusActive
Last updated in NPPESDec 16, 2019
Details
- NPI
- 1639717374
- Entity type
- Organization (NPI-2)
- Legal business name
- Panacea Health Systems LLC
- Organization subpart
- No
- Enumeration date
- Dec 12, 2019
- Certification date
- Dec 16, 2019
- Last updated
- Dec 16, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261Q00000X | Clinic/Center | – | – | Yes |
Practice location
304 N Main StChiefland, FL 32626-0803
Phone 352-414-2270
Mailing address
6600 Sw Highway 200 Ste 300Ocala, FL 34476-5554
Authorized official
Ashwin Kolaventy
Managing Member
3524142270
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