Healthcare Provider Details

I. General information

NPI: 1023329067
Provider Name (Legal Business Name): METRO PHARMACEUTICAL SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2010
Last Update Date: 02/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

126-1 SOUTH CR 315
INTERLACHEN FL
32148
US

IV. Provider business mailing address

126-1 SOUTH CR 315
INTERLACHEN FL
32148
US

V. Phone/Fax

Practice location:
  • Phone: 386-684-0924
  • Fax: 386-684-0926
Mailing address:
  • Phone: 386-684-0924
  • Fax: 386-684-0926

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPH24704
License Number StateFL

VIII. Authorized Official

Name: ADETAYO OLAYINKA
Title or Position: PHARMACIST
Credential:
Phone: 386-684-0924