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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