MEDICARE: TAMPA FAMILY PHARMACY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0004X	Compounding Pharmacy
2	3336S0011X	Specialty Pharmacy
3	333600000X	Pharmacy
4	3336C0003X	Community/Retail Pharmacy	PH25624	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2131723	OTHER	PK
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134400823
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TAMPA FAMILY PHARMACY LLC

Provider Business Mailing Address
First Line	:	12470 TELECOM DR STE 110W
Second Line	:
City	:	TEMPLE TERRACE
State	:	FL
Zip	:	33637-0904
Country	:	US
Telephone Number	:	813-871-5161
Fax Number	:	813-877-2479

Provider Business Practice Location Address
First Line	:	12470 TELECOM DR STE 110W
Second Line	:
City	:	TEMPLE TERRACE
State	:	FL
Zip	:	33637-0904
Country	:	US
Telephone Number	:	813-871-5161
Fax Number	:	813-877-2479

Authorized Official
Title or Position	:	CHIEF PHARMACY OFFICER
Name	:	HANSIL KALARIA
Credential	:
Telephone Number	:	813-871-5161

Provider Enumeration Date	:	09/08/2011
Last Update Date	:	02/11/2026

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Directions to “TAMPA FAMILY PHARMACY LLC ” Practice Location

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