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General NPI Number Information
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NPI Number | 1598478414
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Entity Type | Organization
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Legal Business Name | COMMUNITY PHARMACY
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Dates
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Enumeration Date | 01/05/2023
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Last Update Date | 01/05/2023
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Provider Practice Location Address
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Address Line | 4221 N HIMES AVE
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City | TAMPA
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State | FL
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Zip | 33607-6229
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Country | US
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Telephone | 813-769-0879
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Fax |
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Provider Business Mailing Address
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Address Line | 4054 SAWYER RD
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City | SARASOTA
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State | FL
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Zip | 34233-1272
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Country | US
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Telephone | 941-552-1189
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | VINCE PAYNE
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Credential |
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Telephone | 941-552-1189
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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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