Healthcare Provider Details
I. General information
NPI: 1386969665
Provider Name (Legal Business Name): HUDSON PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/30/2010
Last Update Date: 11/18/2024
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8117 STATE ROAD 52
HUDSON FL
34667-6728
US
IV. Provider business mailing address
8117 STATE ROAD 52
HUDSON FL
34667
US
V. Phone/Fax
- Phone: 727-378-5882
- Fax: 727-378-5883
- Phone: 727-378-5882
- Fax: 727-378-5883
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | PH24554 |
| License Number State | FL |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0004X |
| Taxonomy | Compounding Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CODEY
DULMAINE
Title or Position: CEO
Credential:
Phone: 813-484-1023