Healthcare Provider Details

I. General information

NPI: 1790015188
Provider Name (Legal Business Name): LAMBRIGHT PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2010
Last Update Date: 06/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8890 N 56TH ST
TEMPLE TERRACE FL
33617-6265
US

IV. Provider business mailing address

8890 N 56TH ST
TEMPLE TERRACE FL
33617-6265
US

V. Phone/Fax

Practice location:
  • Phone: 813-988-1985
  • Fax: 813-988-1987
Mailing address:
  • Phone: 813-988-1985
  • Fax: 813-988-1987

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPH24380
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ERIC RUIZ
Title or Position: PIC
Credential:
Phone: 813-877-7971