Organization
TITUSVILLE PHARMACY LLC
Active
Organization
TITUSVILLE PHARMACY LLC
Active
Other names
Titusville Discount Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ARVINDBHAI PATEL (OWNER)
(407) 488-6851
Entity
Organization
Contact information
Practice address
2175 CHENEY HWY STE B, TITUSVILLE, FL 32780-6792
(321) 268-0911
(321) 268-0918
Mailing address
2175 CHENEY HWY STE B, TITUSVILLE, FL 32780-6792
(321) 268-0911
(321) 268-0918
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH25543
FL
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004155200
—
FL
05
—
004155201
—
FL
01
—
2131551
PK
—
Enumeration date
07/05/2011
Last updated
11/21/2014
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