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General NPI Number Information
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NPI Number | 1952785750
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Entity Type | Organization
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Legal Business Name | TAMARAC PHARMACY LLC
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Dates
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Enumeration Date | 07/13/2015
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Last Update Date | 11/30/2022
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Provider Practice Location Address
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Address Line | 7120 N NOB HILL RD
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City | TAMARAC
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State | FL
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Zip | 33321-1841
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Country | US
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Telephone | 954-586-4546
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Fax | 954-586-4004
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Provider Business Mailing Address
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Address Line | 7120 N NOB HILL RD
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City | TAMARAC
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State | FL
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Zip | 33321-1841
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Country | US
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Telephone | 954-586-4546
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Fax | 954-586-4004
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Authorized Official
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Title or Position | AUTHORIZED PERSON
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Name | MITESH PATEL
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Credential |
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Telephone | 954-586-4546
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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 | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PH28905
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License Number State | FL
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