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General NPI Number Information
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NPI Number | 1619534997
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Entity Type | Organization
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Legal Business Name | ULTIMATE PHARMACY LLC
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Dates
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Enumeration Date | 05/22/2019
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Last Update Date | 03/08/2023
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Provider Practice Location Address
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Address Line | 1250 MARINER BLVD
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City | SPRING HILL
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State | FL
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Zip | 34609-5657
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Country | US
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Telephone | 352-592-6340
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Fax | 352-592-6345
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Provider Business Mailing Address
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Address Line | 1250 MARINER BLVD
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City | SPRING HILL
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State | FL
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Zip | 34609-5657
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Country | US
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Telephone | 352-592-6340
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Fax | 352-592-6345
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Authorized Official
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Title or Position | MANAGER
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Name | MR. ABLY TEKLE
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Credential | PHARMD.
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Telephone | 352-592-6340
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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