Healthcare Provider Details

I. General information

NPI: 1417288614
Provider Name (Legal Business Name): METRO PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2010
Last Update Date: 07/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

318 W COLONIAL DR
ORLANDO FL
32801-1109
US

IV. Provider business mailing address

318 W COLONIAL DR
ORLANDO FL
32801-1109
US

V. Phone/Fax

Practice location:
  • Phone: 407-668-4945
  • Fax: 407-704-1469
Mailing address:
  • Phone: 407-668-4945
  • Fax: 407-704-1469

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 NumberPH24560
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ROXANNE BADR
Title or Position: OWNER
Credential:
Phone: 407-668-4368