Provider Demographics
NPI:1871774844
Name:HIRA HEALTHCARE LLC
Entity type:Organization
Organization Name:HIRA HEALTHCARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANIL
Authorized Official - Middle Name:
Authorized Official - Last Name:BAROT
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:407-366-2677
Mailing Address - Street 1:PO BOX 620054
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32762-0054
Mailing Address - Country:US
Mailing Address - Phone:407-366-2677
Mailing Address - Fax:407-366-2535
Practice Address - Street 1:85 GENEVA DR
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-6757
Practice Address - Country:US
Practice Address - Phone:407-366-2677
Practice Address - Fax:407-366-2535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-19
Last Update Date:2014-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 3336C0004X
FL230243336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL032399300Medicaid
FL032399301DMEMedicaid
2149120OtherPK