Healthcare Provider Details

I. General information

NPI: 1730723685
Provider Name (Legal Business Name): ECKERDS RX 107 LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2019
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 N BREVARD AVE
ARCADIA FL
34266-8778
US

IV. Provider business mailing address

710 N BREVARD AVE
ARCADIA FL
34266-8778
US

V. Phone/Fax

Practice location:
  • Phone: 863-485-4150
  • Fax: 863-485-4151
Mailing address:
  • Phone: 863-485-4150
  • Fax: 863-485-4151

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: VIKRAM RAO
Title or Position: PRESIDENT
Credential:
Phone: 941-538-7122