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General NPI Number Information
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NPI Number | 1811468143
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Entity Type | Organization
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Legal Business Name | LIFE PHARMACY INC
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Dates
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Enumeration Date | 12/16/2018
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Last Update Date | 12/16/2018
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Provider Practice Location Address
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Address Line | 4144 LAKEWOOD RANCH BLVD
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City | BRADENTON
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State | FL
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Zip | 34211
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Country | US
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Telephone | 941-417-5433
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Fax | 941-896-6949
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Provider Business Mailing Address
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Address Line | 5306 BENTGRASS WAY
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City | BRADENTON
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State | FL
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Zip | 34211-1700
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Country | US
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Telephone | 941-302-2117
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. JEREMIAH FRANCIS SCHROEDER
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Credential | PHARMD
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Telephone | 941-302-2117
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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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