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General NPI Number Information
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NPI Number | 1942699327
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Entity Type | Organization
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Legal Business Name | SANFORD PHARMACY INC
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Dates
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Enumeration Date | 01/22/2015
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Last Update Date | 01/22/2015
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Provider Practice Location Address
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Address Line | 2541 S FRENCH AVE
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City | SANFORD
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State | FL
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Zip | 32773-5302
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Country | US
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Telephone | 407-915-6637
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Fax | 407-915-6638
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Provider Business Mailing Address
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Address Line | 2541 S FRENCH AVE
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City | SANFORD
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State | FL
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Zip | 32773-5302
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Country | US
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Telephone | 407-915-6637
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Fax | 407-915-6638
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Authorized Official
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Title or Position | OWNER / PHARMACIST
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Name | SUNIL PATEL
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Credential | R.PH.
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Telephone | 407-915-6637
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number | PH28835
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License Number State | FL
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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 | PH28835
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PH28835
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License Number State | FL
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