Healthcare Provider Details

I. General information

NPI: 1114202835
Provider Name (Legal Business Name): MICHAEL GEORGE HURA BS PHARMACY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2011
Last Update Date: 10/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14217 US HIGHWAY 19
HUDSON FL
34667-1170
US

IV. Provider business mailing address

14217 US HIGHWAY 19
HUDSON FL
34667-1170
US

V. Phone/Fax

Practice location:
  • Phone: 727-819-0847
  • Fax: 727-819-3462
Mailing address:
  • Phone: 727-819-0847
  • Fax: 727-819-3462

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS26831
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: