Healthcare Provider Details

I. General information

NPI: 1427288059
Provider Name (Legal Business Name): ASHOK VACHHANI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2009
Last Update Date: 08/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8802 ROCKY CREEK DRIVE. BAY DISCOUNT PHARMACY
TAMPA FL
33615
US

IV. Provider business mailing address

907 LAKE THOMAS LN
LUTZ FL
33548-6477
US

V. Phone/Fax

Practice location:
  • Phone: 813-885-4000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS33084
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: