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General NPI Number Information
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NPI Number | 1518554856
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Entity Type | Organization
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Legal Business Name | SRQ CARE PHARMACY INC
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Dates
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Enumeration Date | 12/21/2020
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Last Update Date | 12/21/2020
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Provider Practice Location Address
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Address Line | 4201 S TAMIAMI TRL
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City | SARASOTA
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State | FL
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Zip | 34231-3627
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Country | US
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Telephone | 941-750-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 4201 S TAMIAMI TRL
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City | SARASOTA
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State | FL
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Zip | 34231-3627
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Country | US
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Telephone | 941-750-1000
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Fax |
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE / CEO
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Name | YELYZAVETA BRAMUROVA
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Credential | PHARMD RPH
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Telephone | 941-759-1000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding 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 |
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License Number State |
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