Healthcare Provider Details

I. General information

NPI: 1720144611
Provider Name (Legal Business Name): S AND S PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9945 TRINITY BLVD STE 107
TRINITY FL
34655-4552
US

IV. Provider business mailing address

9945 TRINITY BLVD STE 107
TRINITY FL
34655-4552
US

V. Phone/Fax

Practice location:
  • Phone: 727-376-7800
  • Fax: 727-376-7855
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPH22447
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: IHAB BARSOUM
Title or Position: PRESIDENT AND PHCY MGR
Credential: RPH
Phone: 813-766-9955