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General NPI Number Information
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NPI Number | 1629514864
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Entity Type | Organization
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Legal Business Name | ST. THOMAS PHARMACY LLC
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Dates
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Enumeration Date | 01/11/2017
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Last Update Date | 12/12/2023
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Provider Practice Location Address
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Address Line | 7200 RIDGE RD STE 106
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City | PORT RICHEY
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State | FL
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Zip | 34668-6971
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Country | US
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Telephone | 727-312-4888
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Fax | 727-312-4889
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Provider Business Mailing Address
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Address Line | 7200 RIDGE RD STE 106
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City | PORT RICHEY
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State | FL
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Zip | 34668-6971
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Country | US
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Telephone | 727-312-4888
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Fax | 727-312-4889
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Authorized Official
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Title or Position | OWNER
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Name | MILLAD KAMEL
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Credential |
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Telephone | 727-312-4888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 30422
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 3104A0630X
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Taxonomy Name | Assisted Living Facility (Behavioral Disturbances)
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License Number | 30422
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 311500000X
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Taxonomy Name | Alzheimer Center (Dementia Center)
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License Number | 30422
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 315D00000X
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Taxonomy Name | Inpatient Hospice
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License Number | 30422
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PH 30422
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License Number State | FL
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