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General NPI Number Information
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NPI Number | 1285143925
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Entity Type | Organization
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Legal Business Name | PA GROUP INC
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Dates
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Enumeration Date | 09/26/2017
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Last Update Date | 01/31/2020
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Provider Practice Location Address
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Address Line | 11618 US HWY 19
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City | PORT RICHEY
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State | FL
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Zip | 34668
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Country | US
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Telephone | 727-819-8200
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Fax | 727-819-9100
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Provider Business Mailing Address
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Address Line | 11618 US HWY 19
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City | PORT RICHEY
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State | FL
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Zip | 34668
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Country | US
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Telephone | 727-819-8200
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Fax | 727-819-9100
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Authorized Official
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Title or Position | PARTNER
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Name | DR. YVONNE K TRAN
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Credential | PHARMACIST
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Telephone | 727-846-1300
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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 | PH30818
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License Number State | FL
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