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General NPI Number Information
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NPI Number | 1437328986
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Entity Type | Organization
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Legal Business Name | KABS OF BRANDON INC
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Dates
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Enumeration Date | 02/28/2008
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Last Update Date | 09/28/2018
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Provider Practice Location Address
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Address Line | 759 W BRANDON BLVD
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City | BRANDON
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State | FL
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Zip | 33511-4901
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Country | US
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Telephone | 813-413-8362
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Fax | 813-413-8370
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Provider Business Mailing Address
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Address Line | 759 W BRANDON BLVD
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City | BRANDON
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State | FL
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Zip | 33511-4901
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Country | US
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Telephone | 813-413-8362
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Fax | 813-413-8370
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Authorized Official
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Title or Position | PRESIDENT
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Name | ROSSANA R VILAR
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Credential |
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Telephone | 786-200-8059
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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 | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PH23179
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License Number State | FL
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