Healthcare Provider Details

I. General information

NPI: 1215832555
Provider Name (Legal Business Name): PRIME CARE PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2176 MARINER BLVD
SPRING HILL FL
34609-3859
US

IV. Provider business mailing address

2176 MARINER BLVD
SPRING HILL FL
34609-3859
US

V. Phone/Fax

Practice location:
  • Phone: 352-600-8083
  • Fax: 352-600-7073
Mailing address:
  • Phone: 352-600-8083
  • Fax: 352-600-7073

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. VENKATESHWARLU THAUDBOINA
Title or Position: MANAGER
Credential:
Phone: 352-600-8083