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General NPI Number Information
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NPI Number | 1710072830
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Entity Type | Organization
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Legal Business Name | WORLD TRIUMPH MEDICAL
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 01/25/2011
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Provider Practice Location Address
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Address Line | 2850 RINGLING BLVD
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City | SARASOTA
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State | FL
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Zip | 34237-5346
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Country | US
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Telephone | 941-366-0090
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Fax | 941-954-5535
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Provider Business Mailing Address
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Address Line | 2850 RINGLING BLVD
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City | SARASOTA
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State | FL
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Zip | 34237-5346
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Country | US
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Telephone | 941-366-0090
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Fax | 941-954-5535
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Authorized Official
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Title or Position | MNGER
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Name | DOUG OLSON
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Credential | CPH
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Telephone | 941-366-0090
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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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Taxonomy #2
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | PH14197
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License Number State | FL
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