Organization
NIA RX SERVICES LLC
Active
Other names
Brandon Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
FALGUN B PATEL RPH (MANAGER)
(813) 420-5436
Entity
Organization
Contact information
Practice address
500 VONDERBURG DR STE 113W, BRANDON, FL 33511-5969
(813) 684-4444
(813) 684-3444
Mailing address
500 VONDERBURG DR STE 113W, BRANDON, FL 33511-5969
(813) 684-4444
(813) 684-3444
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH29589
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016753800
—
FL
01
—
2156208
PK
—
Enumeration date
12/08/2015
Last updated
02/22/2022
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