=====================================================
General NPI Number Information
=====================================================
NPI Number | 1033937792
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PIONEER PHARMACY LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/01/2024
-----------------------------------------------------
Last Update Date | 06/09/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9743 66TH ST N
-----------------------------------------------------
City | PINELLAS PARK
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33782-3008
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 727-513-0873
-----------------------------------------------------
Fax | 727-800-2001
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9743 66TH ST N
-----------------------------------------------------
City | PINELLAS PARK
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33782-3008
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 727-513-0873
-----------------------------------------------------
Fax | 727-800-2001
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. RUSHI BHAKTA
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 727-513-0873
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------