Healthcare Provider Details
I. General information
NPI: 1750496956
Provider Name (Legal Business Name): NATURE COAST PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/20/2006
Last Update Date: 07/20/2021
Certification Date: 07/20/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4662 COMMERCIAL WAY
SPRING HILL FL
34606-1944
US
IV. Provider business mailing address
4662 COMMERCIAL WAY
SPRING HILL FL
34606-1944
US
V. Phone/Fax
- Phone: 352-597-5757
- Fax: 352-597-9595
- Phone: 352-597-5757
- Fax: 352-597-9595
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | PH22203 |
| License Number State | FL |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336L0003X |
| Taxonomy | Long Term Care Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JOSEPH
CRIMA
Title or Position: OWNER
Credential: RPH
Phone: 352-597-5757