=====================================================
General NPI Number Information
=====================================================
NPI Number | 1376280842
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RX CASE II PHARMACY LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/17/2022
-----------------------------------------------------
Last Update Date | 05/17/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1201 PIPER BLVD UNIT 12
-----------------------------------------------------
City | NAPLES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34110
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 239-330-7792
-----------------------------------------------------
Fax | 239-330-7813
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2812 W DR. MARTIN LUTHER KING JR. BLVD
-----------------------------------------------------
City | TAMPA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33607
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | HARDIKKUMAR PATEL
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 973-362-6086
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------