Healthcare Provider Details

I. General information

NPI: 1255781183
Provider Name (Legal Business Name): ANDERSONS THRIF-T DRUGS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2016
Last Update Date: 08/31/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3818 HIGHWAY 90
PACE FL
32571-1014
US

IV. Provider business mailing address

3818 HIGHWAY 90
PACE FL
32571-1014
US

V. Phone/Fax

Practice location:
  • Phone: 850-994-7005
  • Fax: 850-994-6996
Mailing address:
  • Phone: 850-994-7005
  • Fax: 850-994-6996

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPH30187
License Number StateFL

VIII. Authorized Official

Name: DARRELL MILLER
Title or Position: OWNER
Credential:
Phone: 850-433-2165