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General NPI Number Information
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NPI Number | 1689531501
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Entity Type | Organization
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Legal Business Name | PQ PHARMACY
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Dates
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Enumeration Date | 01/05/2026
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Last Update Date | 01/05/2026
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Provider Practice Location Address
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Address Line | 15225 TECHNOLOGY DR
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City | BROOKSVILLE
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State | FL
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Zip | 34604-0692
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Country | US
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Telephone | 352-477-8977
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Fax | 877-456-4512
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Provider Business Mailing Address
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Address Line | 15225 TECHNOLOGY DR
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City | BROOKSVILLE
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State | FL
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Zip | 34604-0692
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Country | US
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Telephone | 352-477-8977
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Fax | 877-456-4512
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Authorized Official
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Title or Position | CEO, PIC
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Name | MR. HALE DIMETRY
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Credential | PHARMD
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Telephone | 201-400-7327
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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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