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NPI Code Detail

MEDICARE: ST PETERSBURG USCG PHCY

MEDICARE: ST PETERSBURG USCG PHCY
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
1332000000XMilitary/U.S. Coast Guard Pharmacy
2333600000XPharmacy

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11016369OTHEROTHER ID NUMBER-COMMERCIAL NUMBER

General Provider Information

NPI Number : 1740387596
Entity Type Code : Organization
Provider Name (Legal Business Name) : ST PETERSBURG USCG PHCY
Provider Business Mailing Address
First Line : 600 8TH AVE SE
Second Line :
City : ST PETERSBURG
State : FL
Zip : 33701-5030
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 600 8TH AVE SE
Second Line :
City : ST PETERSBURG
State : FL
Zip : 33701-5030
Country : US
Telephone Number : 727-502-1586
Fax Number : 727-502-1593
Authorized Official
Title or Position : MGR PHRMCY OPERATIONS CNTR
Name : HECTOR MORALES
Credential :
Telephone Number : 210-221-8443
Provider Enumeration Date : 09/20/2006
Last Update Date : 04/16/2009

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Directions to “ST PETERSBURG USCG PHCY ” Practice Location

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