Organization
SHREY PHARMACY LLC
Active
Organization
SHREY PHARMACY LLC
Active
Other names
PINE BROOK PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GAUTAM THAKKAR RPH (PHARMACY MANAGER)
(813) 454-3500
Entity
Organization
Contact information
Practice address
5340 SPRING HILL DR, SPRING HILL, FL 34606-4562
(352) 610-4437
(352) 610-4427
Mailing address
19107 HARBOR COVE CT, LUTZ, FL 33558-9702
(813) 454-3500
(352) 610-4349
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH25021
FL
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003329000
—
FL
Enumeration date
11/07/2010
Last updated
04/21/2023
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