MEDICARE: IBIS HEALTHCARE INC

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	3336S0011X	Specialty Pharmacy
2	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1578395893
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IBIS HEALTHCARE INC

Provider Business Mailing Address
First Line	:	5707 N 22ND ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33610-4350
Country	:	US
Telephone Number	:	813-239-8545
Fax Number	:

Provider Business Practice Location Address
First Line	:	5707 N 22ND ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33610-4350
Country	:	US
Telephone Number	:	813-239-8545
Fax Number	:

Authorized Official
Title or Position	:	COO
Name	:	JOE LALLANILLA
Credential	:
Telephone Number	:	813-239-8545

Provider Enumeration Date	:	08/15/2024
Last Update Date	:	01/14/2026

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Directions to “IBIS HEALTHCARE INC ” Practice Location

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