MEDICARE: ARMENIA PHARMACY, 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	333600000X	Pharmacy	21152	FL

General Provider Information

NPI Number	:	1720069313
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARMENIA PHARMACY, INC.

Provider Business Mailing Address
First Line	:	8338 N ARMENIA AVE
Second Line	:	STE B
City	:	TAMPA
State	:	FL
Zip	:	33604-2777
Country	:	US
Telephone Number	:	813-832-7574
Fax Number	:	813-931-3867

Provider Business Practice Location Address
First Line	:	8338 N ARMENIA AVE
Second Line	:	STE B
City	:	TAMPA
State	:	FL
Zip	:	33604-2777
Country	:	US
Telephone Number	:	813-832-7574
Fax Number	:	813-931-3867

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. SANDRA E BAKER
Credential	:	RPH
Telephone Number	:	813-932-7574

Provider Enumeration Date	:	11/10/2005
Last Update Date	:	02/01/2008

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