Organization
ST JOSEPH PHARMACY & MEDICAL SUPPLIES LLC
Active
Other names
St Joseph pharmacy & Medical Supplies LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MINIMOL KURIAKOSE BS (PHARMACY MANAGER)
(813) 782-4854
Entity
Organization
Contact information
Practice address
35780 STATE ROAD 54 STE 101, ZEPHYRHILLS, FL 33541-2242
(813) 782-4854
(813) 782-4856
Mailing address
35780 SR 54, SUITE 101, ZEPHYRHILLS, FL 33541-2242
(813) 782-4854
(813) 782-4856
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH24247
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001689600
—
FL
01
—
2122052
PK
—
Enumeration date
08/14/2008
Last updated
02/20/2017
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