Organization
MANASOTA PHARMACY SERVICES LLC
Active
Other names
Bradenton Hometown Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MARTY REISKY (PHARMACIST)
(941) 727-9120
Entity
Organization
Contact information
Practice address
1407 57TH AVE W, BRADENTON, FL 34207-3646
(941) 727-9120
(941) 727-9122
Mailing address
1407 57TH AVE W, BRADENTON, FL 34207-3646
(941) 727-9120
(941) 727-9122
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH25411
FL
3336C0004X
Compounding Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003702200
—
FL
01
—
2132643
PK
—
Enumeration date
07/11/2007
Last updated
03/24/2022
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