Organization
XTRA CARE PHARMACY INC
Active
Organization
XTRA CARE PHARMACY INC
Active
Other names
Xtra Care Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MILDRED PETERSIDE (OWNER/PIC)
(813) 598-0593
Entity
Organization
Contact information
Practice address
6520 US HIGHWAY 301 S STE 106, RIVERVIEW, FL 33578-4324
(813) 280-0927
(813) 677-4500
Mailing address
6520 US HIGHWAY 301 S, SUITE 106, RIVERVIEW, FL 33578-4347
(813) 280-0927
(813) 677-4500
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH26712
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009181900
—
FL
01
—
2140629
PK
—
Enumeration date
06/20/2013
Last updated
02/17/2022
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