Organization
BENAK INCORPORATED
Active
Other names
TAMPA DRUGS AND DIABETIC CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
SMRUTHI JANNU (OWNER, PHARMACY MANAGER,PIC,AO)
(813) 231-7799
Entity
Organization
Contact information
Practice address
3209 N 22ND ST, TAMPA, FL 33605-1937
(813) 231-7788
(813) 232-5210
Mailing address
3209 N 22ND ST, TAMPA, FL 33605-1937
(813) 231-7788
(813) 232-5210
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336I0012X
Institutional Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
PH30610
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2167657
PK
—
Enumeration date
02/13/2017
Last updated
02/20/2017
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