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General NPI Number Information
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NPI Number | 1629270491
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Entity Type | Organization
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Legal Business Name | BOBS PHARMACY & DIABETIC SUPPLIES
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Dates
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Enumeration Date | 06/04/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2860 HIGHWAY 17 NORTH
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City | WINTER HAVEN
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State | FL
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Zip | 33881-1435
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Country | US
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Telephone | 863-293-6084
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Fax | 863-293-8307
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Provider Business Mailing Address
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Address Line | 2860 HWY 17 N
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City | WINTER HAVEN
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State | FL
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Zip | 33881-1435
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Country | US
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Telephone | 863-293-6084
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Fax | 863-293-8307
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Authorized Official
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Title or Position | ADMINISTRATIVE ASST.
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Name | MRS. DANIELLE RODRIGUEZ
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Credential |
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Telephone | 863-293-6084
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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 | PH22556
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License Number State | FL
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