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General NPI Number Information
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NPI Number | 1174906903
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Entity Type | Organization
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Legal Business Name | APEXX PHARMACY
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Dates
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Enumeration Date | 06/29/2015
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Last Update Date | 06/29/2015
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Provider Practice Location Address
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Address Line | 10343 STATE ROAD 52
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City | HUDSON
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State | FL
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Zip | 34669-3097
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Country | US
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Telephone | 727-857-6065
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Fax | 727-857-6066
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Provider Business Mailing Address
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Address Line | 10343 STATE ROAD 52
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City | HUDSON
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State | FL
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Zip | 34669-3097
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Country | US
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Telephone | 727-857-6065
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Fax | 727-857-6066
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Authorized Official
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Title or Position | OWNER/PHARMACIST
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Name | DR. NATHANIEL OVOREVARIE ESALOMI
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Credential | PHARM. D
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Telephone | 813-362-3155
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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 | PS38307
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PH29144
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License Number State | FL
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