Healthcare Provider Details

I. General information

NPI: 1801347190
Provider Name (Legal Business Name): SEFFNER HEALTH PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2016
Last Update Date: 02/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10907 E US HIGHWAY 92 STE D
SEFFNER FL
33584-3231
US

IV. Provider business mailing address

10907 E US HIGHWAY 92 STE D
SEFFNER FL
33584-3231
US

V. Phone/Fax

Practice location:
  • Phone: 813-405-8900
  • Fax: 813-614-9133
Mailing address:
  • Phone: 813-405-8900
  • Fax: 813-614-9133

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPH30419
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MOHAMMAD ZAYED
Title or Position: OWNER/PHARMACIST
Credential:
Phone: 813-405-8900