MEDICARE: UGALAND INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	PH0030364	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2120858	OTHER		PK

General Provider Information

NPI Number	:	1710114210
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UGALAND INC

Provider Business Mailing Address
First Line	:	PO BOX 310256
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33680-0256
Country	:	US
Telephone Number	:	813-248-5405
Fax Number	:	813-248-5408

Provider Business Practice Location Address
First Line	:	2113 E 93RD AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33612-8636
Country	:	US
Telephone Number	:	813-248-5408
Fax Number	:	813-915-3446

Authorized Official
Title or Position	:	PRESIDENT/RX MANAGER
Name	:	CHRISTIAN NWOYE
Credential	:	B.PHARM
Telephone Number	:	813-270-3712

Provider Enumeration Date	:	06/11/2009
Last Update Date	:	03/17/2017

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Directions to “UGALAND INC ” Practice Location

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