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Organization

NORTHSIDE MENTAL HEALTH CENTER, INC.

Active
Other names
Northside Mental Health Hospital, Inc.
Organization subpart
No

Provider details

NPI number
Authorized official
MARY FUMEA (PHARMACIST)
(813) 977-8700
Entity
Organization

Contact information

Practice address
12512 BRUCE B DOWNS BLVD, TAMPA, FL 33612-9209
(813) 977-8700
Mailing address
12512 BRUCE B DOWNS BLVD, TAMPA, FL 33612-9209
(813) 977-8700

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
PH6478
FL
251S00000X
Community/Behavioral Health Agency
Primary
PH8142
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PH6478
INSTITUTIONAL CLASS PHARM
FL
01
PH8142
COMMUNITY PHARMACY
FL
Enumeration date
04/12/2007
Last updated
08/22/2020
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