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General NPI Number Information
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NPI Number | 1003837345
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Entity Type | Organization
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Legal Business Name | PELOT'S PHARMACY
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Dates
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Enumeration Date | 07/22/2006
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Last Update Date | 03/22/2010
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Provider Practice Location Address
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Address Line | 831 MANATEE AVE E
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City | BRADENTON
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State | FL
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Zip | 34208-1243
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Country | US
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Telephone | 941-748-8130
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Fax | 941-749-5406
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Provider Business Mailing Address
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Address Line | 831 MANATEE AVE E
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City | BRADENTON
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State | FL
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Zip | 34208-1243
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Country | US
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Telephone | 941-748-8130
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Fax | 941-749-5406
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Authorized Official
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Title or Position | OWNER/PHARMACIST
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Name | MR. ROBERT L PELOT
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Credential | RPH
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Telephone | 941-748-8130
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS0012705
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License Number State | FL
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