Healthcare Provider Details

I. General information

NPI: 1851418149
Provider Name (Legal Business Name): TOWN PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2007
Last Update Date: 06/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14826 TAMIAMI TRAIL
NORTH PORT FL
34287
US

IV. Provider business mailing address

14826 TAMIAMI TRAIL
NORTH PORT FL
34287
US

V. Phone/Fax

Practice location:
  • Phone: 941-429-7766
  • Fax: 941-429-1105
Mailing address:
  • Phone:
  • Fax:

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 Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License NumberPH22492
License Number StateFL

VIII. Authorized Official

Name: ALEX SHULMAN
Title or Position: PRESIDENT
Credential:
Phone: 941-429-7766