=====================================================
General NPI Number Information
=====================================================
NPI Number | 1295526648
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RX CARE OF TAMPA, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/15/2025
-----------------------------------------------------
Last Update Date | 05/15/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5138 N FLORIDA AVE
-----------------------------------------------------
City | TAMPA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33603-2154
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 813-249-6593
-----------------------------------------------------
Fax | 727-748-4277
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 701 94TH AVE N STE 250
-----------------------------------------------------
City | ST PETERSBURG
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33702-2448
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 727-321-3854
-----------------------------------------------------
Fax | 727-321-7670
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | RAJWANTIE RAJKUMAR
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 727-321-3854
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 333600000X
-----------------------------------------------------
Taxonomy Name | Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------