Healthcare Provider Details

I. General information

NPI: 1609231331
Provider Name (Legal Business Name): OUSIA PHARMACY CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2015
Last Update Date: 09/19/2024
Certification Date: 09/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5194 MARINER BLVD
SPRING HILL FL
34609
US

IV. Provider business mailing address

5194 MARINER BLVD
SPRING HILL FL
34609
US

V. Phone/Fax

Practice location:
  • Phone: 813-252-4076
  • Fax: 320-455-9299
Mailing address:
  • Phone: 813-252-4076
  • Fax: 320-455-9299

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 NumberPH29616
License Number StateFL

VIII. Authorized Official

Name: MRS. DENISE SCHRADE
Title or Position: OWNER
Credential:
Phone: 320-405-9504