Healthcare Provider Details

I. General information

NPI: 1306147319
Provider Name (Legal Business Name): SHREY PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2010
Last Update Date: 04/21/2023
Certification Date: 04/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5340 SPRING HILL DR
SPRING HILL FL
34606-4562
US

IV. Provider business mailing address

19107 HARBOR COVE CT
LUTZ FL
33558-9702
US

V. Phone/Fax

Practice location:
  • Phone: 352-610-4437
  • Fax: 352-610-4427
Mailing address:
  • Phone: 813-454-3500
  • Fax: 352-610-4349

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPH25021
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. GAUTAM THAKKAR
Title or Position: PHARMACY MANAGER
Credential: RPH
Phone: 813-454-3500