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General NPI Number Information
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NPI Number | 1154727519
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Entity Type | Organization
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Legal Business Name | FORT PIERCE DISCOUNT PHARMACY, INC.
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Dates
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Enumeration Date | 11/13/2014
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Last Update Date | 07/13/2015
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Provider Practice Location Address
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Address Line | 1727 OKEECHOBEE RD
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City | FORT PIERCE
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State | FL
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Zip | 34950-3945
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Country | US
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Telephone | 772-873-3743
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Fax | 772-577-6657
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Provider Business Mailing Address
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Address Line | 1727 OKEECHOBEE RD
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City | FORT PIERCE
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State | FL
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Zip | 34950-3945
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Country | US
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Telephone | 772-577-6469
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Fax | 772-577-6657
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Authorized Official
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Title or Position | PHARMACY MANAGER
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Name | SONIA SHARMA
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Credential | RPH
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Telephone | 772-577-6469
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PH28682
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License Number State | FL
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