Organization
EN-VISION HEALTH SERVICES LLC
Active
Other names
HEALTH PRO PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MISS MADHUMATHI PULLELA (OWNER)
(813) 784-5590
Entity
Organization
Contact information
Practice address
11349 BIG BEND RD, RIVERVIEW, FL 33579-7183
(813) 672-8889
Mailing address
11349 BIG BEND RD, RIVERVIEW, FL 33579-7183
(813) 672-8889
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PH27174
FL
3336C0003X
Community/Retail Pharmacy
PH27174
FL
3336L0003X
Long Term Care Pharmacy
PH27174
FL
3336S0011X
Specialty Pharmacy
PH27174
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PH27174
STATE LICENSE
FL
Enumeration date
11/06/2013
Last updated
07/31/2015
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