Healthcare Provider Details

I. General information

NPI: 1801728670
Provider Name (Legal Business Name): CHARIS PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/13/2026
Certification Date: 06/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

775 PRIMERA BLVD STE 1031
LAKE MARY FL
32746-2190
US

IV. Provider business mailing address

775 PRIMERA BLVD STE 1031
LAKE MARY FL
32746-2190
US

V. Phone/Fax

Practice location:
  • Phone: 407-603-1633
  • Fax: 321-204-7073
Mailing address:
  • Phone: 407-603-1633
  • Fax: 321-204-7073

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ELIZABETH MAKAR
Title or Position: PHARMACY MANAGER
Credential: PHARMD
Phone: 352-434-9693