MEDICARE: CHRIST 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
2	3336C0003X	Community/Retail Pharmacy	PH29252	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5727396	OTHER		NCPDP

General Provider Information

NPI Number	:	1992180897
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHRIST PHARMACY INC

Provider Business Mailing Address
First Line	:	3952 S SUNCOAST BLVD
Second Line	:
City	:	HOMOSASSA
State	:	FL
Zip	:	34448-2601
Country	:	US
Telephone Number	:	352-765-4743
Fax Number	:	352-765-4703

Provider Business Practice Location Address
First Line	:	3952 S SUNCOAST BLVD
Second Line	:
City	:	HOMOSASSA
State	:	FL
Zip	:	34448-2601
Country	:	US
Telephone Number	:	352-765-4743
Fax Number	:	352-765-4703

Authorized Official
Title or Position	:	OWNER
Name	:	EIHAB H TAWFIK
Credential	:
Telephone Number	:	352-765-4743

Provider Enumeration Date	:	07/21/2015
Last Update Date	:	10/31/2018

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Directions to “CHRIST PHARMACY INC ” Practice Location

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