is a Non-pharmacy Dispensing Site in Tampa, Florida. practices all healthcare services and medical treatments related to Non-pharmacy Dispensing Site. The NPI Number for is 1962552299. The last update date is .
's current location address is 4919 Memorial Hwy Ste 200, Tampa, Florida. You can contact this provider via phone number 8135696500. The mailing address for is 4919 Memorial Hwy Ste 200, Tampa, Florida. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 4919 Memorial Hwy Ste 200, Tampa, Florida |
| Phone Number | 8135696500 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1962552299 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 4919 Memorial Hwy Ste 200 |
|---|---|
| City | Tampa |
| State | Florida (FL) |
| Post Code | 336347500 |
| Phone Number | 8135696500 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Non-pharmacy Dispensing Site |
|---|---|
| Taxonomy | 332900000X |
| Licence No | ME0054890 |
|
Definition: A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 64122700 | FL | -- | |
| 1024188 | OTHER ID NUMBER-COMMERCIAL NUM |
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