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General NPI Number Information
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NPI Number | 1114166691
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Entity Type | Organization
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Legal Business Name | MNR GROUP LLC
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Dates
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Enumeration Date | 02/06/2009
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Last Update Date | 02/16/2017
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Provider Practice Location Address
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Address Line | 6113 STATE ROAD 54
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City | NEW PORT RICHEY
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State | FL
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Zip | 34653-6004
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Country | US
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Telephone | 727-849-6000
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Fax | 727-849-6007
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Provider Business Mailing Address
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Address Line | 6113 STATE ROAD 54
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City | NEW PORT RICHEY
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State | FL
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Zip | 34653-6004
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Country | US
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Telephone | 727-849-6000
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Fax | 727-849-6007
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Authorized Official
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Title or Position | OWNER / MANAGER
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Name | JOSEPH GHALLY
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Credential | RPH
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Telephone | 727-488-3708
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PH23779
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License Number State | FL
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