Healthcare Provider Details

I. General information

NPI: 1417275694
Provider Name (Legal Business Name): JEBA INVESTMENTS GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2010
Last Update Date: 02/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8802 ROCKY CREEK DR STE 101
TAMPA FL
33615-4315
US

IV. Provider business mailing address

8802 ROCKY CREEK DR #101
TAMPA FL
33615-4315
US

V. Phone/Fax

Practice location:
  • Phone: 813-885-4000
  • Fax: 813-885-4008
Mailing address:
  • Phone: 813-885-4000
  • Fax: 813-885-4008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License NumberPH24594
License Number StateFL

VIII. Authorized Official

Name: JULIUS BEN-ACQUAAH
Title or Position: CLINICAL PHARMACIST
Credential:
Phone: 813-885-4000