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General NPI Number Information
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NPI Number | 1346754777
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Entity Type | Organization
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Legal Business Name | MALOOKA PHARMA CORP
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Dates
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Enumeration Date | 11/21/2017
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Last Update Date | 06/11/2018
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Provider Practice Location Address
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Address Line | 8618 E STATE ROAD 70
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City | BRADENTON
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State | FL
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Zip | 34202-3785
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Country | US
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Telephone | 941-751-5000
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Fax | 941-751-5002
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Provider Business Mailing Address
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Address Line | 8618 EAST SR 70
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City | BRADENTON
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State | FL
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Zip | 34202
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Country | US
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Telephone | 941-751-5000
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Fax | 941-751-5002
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Authorized Official
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Title or Position | OWNER
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Name | HAMED ABOUZEID
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Credential |
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Telephone | 973-479-8032
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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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 | PH31161
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License Number State | FL
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