Organization
ONE SOURCE PHARMACY, LLC
Active
Parent organization
ONE SOURCE PHARMACY, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
ONE SOURCE PHARMACY, LLC
Authorized official
MR. INDRAJIT VYAS (OWNER/ MGR)
(877) 490-8987
Entity
Organization
Contact information
Practice address
6404 OLD WINTER GARDEN RD, STE 100, ORLANDO, FL 32835
(877) 490-8987
(877) 490-1060
Mailing address
6404 OLD WINTER GARDEN RD, SUITE 250, ORLANDO, FL 32835
(877) 490-8987
(877) 490-1060
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH25399
FL
3336M0002X
Mail Order Pharmacy
PENDING
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003464100
—
FL
Enumeration date
01/29/2008
Last updated
06/29/2011
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