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General NPI Number Information
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NPI Number | 1164545083
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Entity Type | Organization
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Legal Business Name | PHARMACY OF AMERICA, LLC
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Dates
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Enumeration Date | 04/07/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2613 CENTERVILLE RD
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City | TALLAHASSEE
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State | FL
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Zip | 32308-4503
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Country | US
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Telephone | 850-385-3073
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Fax | 813-830-7492
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Provider Business Mailing Address
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Address Line | 2613 CENTERVILLE RD
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City | TALLAHASSEE
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State | FL
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Zip | 32308-4503
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Country | US
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Telephone | 850-385-3073
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Fax | 813-830-7492
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. RODNEY SYDNOR
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Credential |
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Telephone | 813-952-7182
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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 | PS13512
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License Number State | FL
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