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General NPI Number Information
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NPI Number | 1265730345
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Entity Type | Organization
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Legal Business Name | MIDTOWN APOTHECARY INC.
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Dates
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Enumeration Date | 03/14/2011
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Last Update Date | 10/31/2024
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Provider Practice Location Address
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Address Line | 2136 W MLK BLVD STE A
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City | TAMPA
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State | FL
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Zip | 33607-6512
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Country | US
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Telephone | 813-527-0765
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Fax | 813-644-6992
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Provider Business Mailing Address
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Address Line | 2136 W DR MARTIN LUTHER KING JR BLVD
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City | TAMPA
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State | FL
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Zip | 33607-6512
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Country | US
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Telephone | 813-527-0765
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Fax | 813-644-6992
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Authorized Official
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Title or Position | OWNER
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Name | WALE JULIUS
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Credential |
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Telephone | 813-536-7291
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number | PH25711
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PH25711
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License Number State | FL
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