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General NPI Number Information
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NPI Number | 1770828741
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Entity Type | Organization
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Legal Business Name | ALPHA-OMEGA PHARMACY
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Dates
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Enumeration Date | 12/03/2012
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Last Update Date | 03/31/2017
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Provider Practice Location Address
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Address Line | 4625 E BAY DR STE 313
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City | CLEARWATER
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State | FL
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Zip | 33764-5747
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Country | US
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Telephone | 844-557-0835
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Fax | 800-563-2710
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Provider Business Mailing Address
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Address Line | 4625 E BAY DR STE 313
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City | CLEARWATER
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State | FL
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Zip | 33764-5747
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Country | US
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Telephone | 844-557-0835
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Fax | 800-563-2710
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Authorized Official
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Title or Position | OWNER
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Name | BRYAN HOLMES
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Credential |
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Telephone | 844-557-0835
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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 | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PH26538
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License Number State | FL
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