=====================================================
General NPI Number Information
=====================================================
NPI Number | 1871448977
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BELL PHARMACY 008 LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/03/2026
-----------------------------------------------------
Last Update Date | 03/03/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2251 DREW ST STE B
-----------------------------------------------------
City | CLEARWATER
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33765-3306
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-760-7351
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2251 DREW ST STE B
-----------------------------------------------------
City | CLEARWATER
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33765-3306
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-760-7351
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMIN
-----------------------------------------------------
Name | JACOB VANDEVENTER
-----------------------------------------------------
Credential | PHARMD
-----------------------------------------------------
Telephone | 407-760-7351
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------