Healthcare Provider Details

I. General information

NPI: 1912907205
Provider Name (Legal Business Name): BETTER CARE PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2005
Last Update Date: 07/21/2020
Certification Date: 07/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4860 RUCKER RD STE 1
MONETA VA
24121-5281
US

IV. Provider business mailing address

5908 BRECKENRIDGE PKWY
TAMPA FL
33610-4233
US

V. Phone/Fax

Practice location:
  • Phone: 540-297-8640
  • Fax: 540-297-8650
Mailing address:
  • Phone: 813-304-2221
  • Fax: 888-239-8423

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number0201003521
License Number StateVA

VIII. Authorized Official

Name: TONYA SHACKELFORD
Title or Position: PRESIDENT
Credential:
Phone: 813-304-2221