Organization
ITANI FAMILY PHARMACY PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BASIL ITANI PHARMD (OWNER)
(321) 269-7772
Entity
Organization
Contact information
Practice address
2507 GARDEN ST, TITUSVILLE, FL 32796-4612
(321) 269-7772
Mailing address
2507 GARDEN ST, TITUSVILLE, FL 32796-4612
(321) 269-7772
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH25723
FL
Other
Enumeration date
10/31/2011
Last updated
10/31/2011
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