Healthcare Provider Details

I. General information

NPI: 1598362519
Provider Name (Legal Business Name): FAST & FRIENDLY LTC PHARMACY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2020
Last Update Date: 10/02/2020
Certification Date: 10/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3202 W BAKER ST
PLANT CITY FL
33563-2849
US

IV. Provider business mailing address

3202 W BAKER ST
PLANT CITY FL
33563-2849
US

V. Phone/Fax

Practice location:
  • Phone: 813-704-6857
  • Fax: 813-756-6938
Mailing address:
  • Phone: 813-704-6857
  • Fax: 813-756-6938

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. HAIDEE PRENIL ADEYEMO
Title or Position: OWNER
Credential: BSN
Phone: 813-704-6857