Organization
TAVARES PHARMACY LLC
Active
Organization
TAVARES PHARMACY LLC
Active
Other names
TAVARES PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MD ANWAR (PHARMACIST-IN-CHARGE)
(352) 455-3483
Entity
Organization
Contact information
Practice address
524 S DUNCAN DR, TAVARES, FL 32778-4146
(352) 508-6449
(352) 508-6448
Mailing address
524 S DUNCAN DR, TAVARES, FL 32778-4146
(352) 508-6449
(352) 508-6448
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH25697
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004350300
—
FL
01
—
2132257
PK
—
Enumeration date
10/07/2011
Last updated
02/28/2017
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